76 year old male with anasarca and sob
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Patient came to casualty with
C/O :
1) B/L pedal edema since 1 month
2)Burning micturition since 1 week
3)Shortness of breath since 5 days
4)Decreased urine output since 3 days
5)Anasarca since 3 days
HOPI:
Patient was apparently asymptomatic 1 month back then he developed B/L pedal edema which is pitting type initially upto ankle later progressed upto knee
Shortness of breath since 5 days, insidious onset, gradually progressive(from grade 1 to 2)
No H/O orthopnea, PND. No H/O fever, cough, vomitings, loose stools.
Generalised swelling of body since 3 days, B/l upper limb edema and abdominal distension since 3 days
TIME LINE OF THE DISEASE :
1 month back swelling was observed in ankles
On 22-07-23, swelling started to progress from Ankle towards leg
Patient started to experience Shortness of breath
On 24-07-23, he went to local hospital with C/O burning micturition
He was given some medication ( not known)
According to patient swelling started to progress rapidly after taking the medication
By 26 th swelling progressed to entire body
He was taken to local hospital, patient got initial tests done here
Serum creat-3mg/dl
Usg : grade 1 RPD and b/l pleural effusion
He was referred to kamineni i/v/o raised creatinine and RPD changes ( according to patient - for dialysis)
PAST HISTORY :
Patient has H/O Type 2 DM since 10 years ( medication - not known)
No H/O HTN, Asthma, TB, Epilepsy, CVA, CAD
No past surgical history
PERSONAL HISTORY :
DIET - mixed
Appetite-normal
SLEEP - adequate
BOWEL/BLADDER-regular
ADDICTIONS - alcohol consumption since 40 yrs
Chutta - 10 / day since 40 yrs
NO ALLERGIES
FAMILY HISTORY :
No significant family history
GENERAL EXAMINATION :
No signs of pallor, icterus, cyanosis, clubbing, Lymphadenopathy
Pedal edema present
edema present
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