22 year old female

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CASE

22 year old female housewife resident of Nalgonda district came to OPD on 10th June 2022 

With the chief complaints of

* generalized swelling of body since 5 days 

* reduced urine output since 5 days 

* shortness of breath since 5 days 

HISTORY OF PRESENTING ILLNESS 

Paitent was apparently asymptomatic 5 days ago then she had developed generalized swelling and reduced urine output 

No complaints of palpitations, cold, cough, burning micturition fever,chest pain,

PAST HISTORY 

In 2010 when Paitent was 10 years old marked 

*increased appetite

* increased urine output

*increased thirst 

Were noted and she was taken to a local hospital where she was diagnosed with DIABETES and is on insulin therapy from then  

In 2021

When she went to a regular check up she was diagnosed with hypertension from then she is on regular medication

* tablet Telma 40mg

*tablet Nicardia 20 mg 

 In May 2022

When she was 22 years old she had developed 

*facial puffiness 

*odema in feet 

* shortness of breath 

Grade IV

Where she was treated with dialysis and was send home 

JUNE 2022(Presently)

after 15days of dialysis treatment Paitent had again developed 

*generalized oedema

* reduced urine output 

* loss of appetite 

* vomiting 

Paitent is a know case of 

*diabetes melittus since past 12 years 

*hypertension since 1 year 

Not a know case of asthma epilepsy tuberculosis 

PERSONAL HISTORY 

appetite - reduced since 15 days 

Diet - mixed 

Bladder movements - reduced 

Bowel movements - reduced 

allergy  - Not known

Addiction - NIL

ON EXAMINATION 

Pallor present 

NO 

icterus

 cyanosis

 clubbing 

lymphadenopathy 

 oedema present 

VITALS 

ON 14TH 

PR 86 bpm

BP 180/100mm hg

RR 24 cpm

Spo2 97%

SYSTEMIC EXAMINATION 

CVS: S1 S2 heard 

         No murmur heard 

RS: bilateral crepitus heard 

CNS: Crainial Nevers intact 

         Motor system intact

         Sensory pain temp touch vibration well appreciated 

Per Abdominal :

Inspection:  distendent 

                      Flanks full

                      Umbilicus center.                           

Palpation : soft and non tender 

                   No organomegaly 

Percussion fluid thrill present 

DAIGONOSIS 

CKD ON MHD

TREATMENT 

Injection 

PIPTAZ 2.25gm /TID/IV

PAN IV/BD

ZOFER IV/TID

Lasix 60 mg /BD

tablet 

NICARDIA 20 MG /BD

TELMA 40 MG /OD

OROFER-X5 PO/OD

NODOSIS 500 MG PO/BD

SHELCAL 500MG/PO/OD