GM case 9

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A 27 year old male who is student from nalgonda came to the opd with chief complaints of pedal edema  since 2years .

He also had vomiting and decreased urine output since 1mon

History of present illness:

 Patient was apparently asymptomatic 2yrs back then he developed persistent vomiting for about 2mon ,then he noticed bilateral pedal edema of pitting type which is insidious in onset ,for which he visited to local hospital and got to be told have some kidney issue and received medication and got relieved for some period of time.

After 1month  he again developed  vomiting and bilateral pedal edema of pitting type, decreased urine output .

Past history:

Since 2yrs he is on dialysis twice a week .

Patient was diagnosed with tuberculosis 6 months back.

 He has hypertension since 2 years.

No history of bronchial asthma,epilepsy.

No history of diabetes. 

No history of previous surgeries.

Personal history:

Diet:mixed

Appetite Normal

Sleep decreased 

Bowel movement are regular

Bladder:Decreased urine output 

No addiction 

Family history:

No similar complaints in the family. 

Drug history:

No allergy to known drugs.

General examination:

 Patient is conscious,coherent, cooperative. 

 pallor was present 

No cyanosis 

No lymphadenopathy 

No clubbing 

No icterus 

No edema

No tremors 

Bilateral pedal edema was present. 

Vitals:

Temperature:afebrile

BP:140/90mmHg

Pulse:92/min

Respiratory rate:24/min








Systemic examination:- 

   Cvs 

  S1 and s2 are heard .

 Respiratory system 

No dyspnoea 

Position of trachea central .

Abdomen:

Shape of abdomen-scaphoid

Tenderness-No
 Palpable mass-No

CNS

   Patient is conscious 

Speech is normal 

Provisional diagnosis:

Ckd on mhd

Investigations:






Treatment:


Tab Lasix 40 mg BD

Tab Nodosis 500mg  BD

Tab shelcal OD

 Tab Pantop 40 mg OD

Inj Erythropoietin 4000IU once weekly

Inj Iron Sucrose 100mg once weekly

Tab Nicardia 20 mg BD

On Anti tubercular drugs since 6months 







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