General medicine 7
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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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