General medicine 7

 This is online E log book to discuss our patient's de-identified health data shared after taking his/her/guardian's signed informed consent. Here we discuss our individual patient's problems through series of inputs from available global online community of experts with an aim to solve those patients clinical problems with collective current best evidence based inputsThis e-log book also reflects my patient centered online learning portfolio and your valuable inputs on comment box is welcome".

39 k.meghana, 37 K.sai likhitha

 A 22 year old female who is haliling from miryalaguda who is a student by occupation visited our op with cheif complaint of blurring of vision, sob.

History of present illness:

Before 1 year Patient vistited department of opthamalogy due to blurring of vision before visiting the hospital .They did several diagnosis and confirmed that there is nothing wrong with her eyes and referred for whole systemic examination.In diagnosis is was conformed as kidney failure.

She visited several other hospitals in nalgonda then she reffered here she came from past 11 mon .She is recieving dialysis- weekly twice in our hospital.In the past few months when she on dialysis several times she is suffering from headache ,cough and fever sometimes.

Past history:

She had no similar complaints in the past. 

She has hypertension since 2years 

 No h/o diabetes 

No h/o epilepsy

No h/o TB

No h/o asthma 

No history of any previous surgery in the past. 

Personal history:

 Appetite:normal 

Diet:mixed 

Sleep-inadequate 

Bowel-decreased urine output

bladder movements :normal 

 No addictions 

Family history:

No similar complaints in the family. 

Drug history:

No allergy to known drugs.

General examination:

 Patient is conscious,coherent, cooperative. 

Pallor is present 

No cyanosis 

No lymphadenopathy 

No clubbing 

No icterus 

No edema

No tremors 



Vitals:

Temp:afebrile

Pulse rate:85/min

RR:15/min

 Bp:160/80

Systemic examination:- 

   Cvs 

  S1 and s2 are heard .

 Respiratory system 

No dysponea 

Position of trachea central .

Abdomen:

Soft and non tender  

CNS

   Patient is conscious 

Speech is normal 



Investigations:

ECG:








Final diagnosis:

 Ckd and mhd

Treatment:

Tab lasix 40mg po/bd

Tab nicardia 20mg po/tid

Tab nodosis 500mg po/bd 

Inj erythropoietin 4000 iu/sc weekly once 

Tab livogen po/bd

Tab shelcal ct 500mg po/bd

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