50 YEAR OLD FEMALE WITH DECREASED URINE OUTPUT
50 YEAR OLD FEMALE WITH DECREASED URINE OUTPUT
Patient came to casualty with
C/O DECREASED URINE OUTPUT SINCE 1 month.
C/O FACIAL PUFFINESS SINCE 1 MONTH
C/O MILD SOB SINCE - 1 MONTH
C/O DECREASED APPETITE SINCE 1 MONTH
HISTORY OF PRESENT ILLNESS
PATIENT WAS APPARENTLY ASYMPTOMATIC THEN SHE DEVELOPED GIDDINESS AND VOMITINGS (2-3episodes )WENT TO A LOCAL HOSPITAL IN GURUJALA AND THERE SHE WAS DIAGNOSED WITH HYPERTENSION GRADE 3 (180/100 MM HG ) AND THEN SHE WAS TREATED WITH telma 40mg , amlodepine 5mg , metoprolol 50 mg .
And then after using medications her bp was uncontrolled then they went to miryalguda for uncontrolled hypertension and decreased appetite (1 idly at 8am ,50 grms of rice at 11 am , 50ml Ragi malt at 3 pm, 50ml of milk at 7pm)and decreased urine output .
H/O shortness of breath since 1 month and present only on walking for 15 mins and relieved on sitting .
History of past illness :
Not a k/c/o DM,TB, BA, Epilepsy
And Thyroid disorders.
Personal history:
Diet - mixed
Appetite - decreased since one month
Bowel movements: regular
Bladder movements : decreased
Sleep : adequate
No addictions and allergies
Family history : insignificant
NSAID ABUSE since 1yr (post covid).
Pt is C/C/C
Well oriented
Pallor present
No signs of icterus, clubbing, koilonychia, lymphadenopathy and clubbing.
Temp: afebrile
Pulse rate :88bpm
Resp rate : 16cpm
Blood pressure: 130/90 mm hg
Systemic examination:
CVS - S1, S2 heard
Respiratory system - NVBS, BAE
Per abdomen -soft and non tender
CNS - NFND
Provisional diagnosis :
ACUTE RENAL FAILURE with HTN
Usg abd and pelvis :
Ecg :
Hemogram :
Lft :
Rft :
ABG
Dialysis session 1: 6/4/22
RFT:
CBP:
Dialysis session 2 : 7/4/22
Treatment :
1)INJ LASIX 40 mg IV/BD
2)INJ PAN 40 mg IV /OD
3)INJ ZOFER 4mg IV /SOS
4)INJ ERYTHROPOIETIN 5000 IV S/C ONCE WEEKLY
5)TAB NICARDIA 10mg PO/BD
6)TAB NODOSIS 500mg PO/BD
7)TAB OROFER -XT PO/OD
8)TAB MVT PO/OD
