This is an online E logbook to discuss our patient's de-identified health data shared after taking his/her/guardian's signed informed consent. Here, we discuss our individual patient's problems through a series of inputs from an available global online community of experts with an aim to solve those patients' clinical problems with collective current best evidence-based inputs.


CHIEF COMPLAINTS:- A 55 year old woman came to opd with

  1. Bilateral swelling of legs and Shortness of                 breath since 10 days 

  2. Anuria  since 10 days


HISTORY OF PRESENT ILLNESS :

The patient was asymptomatic 2 years back until she developed pain in her lower back region which radiates to the anterior groin region.

The lower back Pain Is Dull Aching type Continuous type.

She first noticed pedal oedema 1 year back which was on and off.

The Lower back ache associated with Pedal oedema aggrevated in last 10 days.

The Patient is On Maintainance Hemodialysis since 4 month.


HISTORY OF PAST ILLNESS:

The patient is was diagnosed with Hypertension 2 yrs back

No h/o epilepsy, tuberculosis.

PERSONAL HISTORY:

The patient consumes mixed diet.

There is loss of appetite, 

-Has normal sleep.

-Has decreased urine output 

Bowels is regular

The Patient Occasional Alcoholic and a Smoker.


FAMILY HISTORY:

There is no significant family history .


GENERAL EXAMINATION:

The patient is conscious coherent and cooperative.

                -Pallor present

                -No icterus

               -No cyanois

               -No clubbing of fingers and toes.

               -No lymphadenopathy

               - Bilateral pedal edema present.

VITALS:

              Temperature- afebrile,

               Pulse rate- 99 bpm

               Respiratory rate- 22 times per minute

               Blood pressure- 110/80 mm hg








SYSTEMIC EXAMINATION:

CARDIOVASCULAR SYSTEM:

- S1 & S2 heard

- Murmurs absent

 RESPIRATORY SYSTEM:

Position of trachea - central

Normal vesicular breath sounds heard

No wheezes heard


ABDOMEN :

-Shape of abdomen- Scaphoid

-No Palpable mass 

-No Free fluid present

- Liver-Not palpable

- Bowel sounds - Heard


INVESTIGATIONS :

HEMOGRAM



RENAL FUNCTION TEST


ECG

Diagnosis : CKD ON MHD

Treatment :
- Salt restrictions < 2.4gm/day
- Fluid Restriction < 1 Litre per day
- Tab.LASIX
-Tab.NODISIS
Tab.SHELCAL
- Inj. Erythropoietin

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