Final Short

A 70 year old Female labourer by occupation came with chief complaints of

- Decreased urine output since 20days
- Burning micturition since 20 days
- Urgency and hesitency of micturition since 20 days
- Mass per abdomen since 15 days


HISTORY OF PRESENT ILLNESSES 
The patient was apparently asymptomatic 20 days back ,then she noticed a decrease in her urine output , burning micturition,urgency and hesitency of micturition.
She denies H/o fever, loin pain, hematuria.

PAST HISTORY

Not a k/c/o T2DM,HTN,asthma , epilepsy,TB 

PERSONAL HISTORY
Diet - mixed
Appetite - normal
Sleep- adequate
Bowel movements- normal

GENERAL PHYSICAL EXAMINATION
Pt is conscious, coherent, cooperative, 
 Vitals-
Temp- afebrile 
Bp-90/50 mm hg
Pr- 86 bpm
Rr-20 cpm
Spo2- 98% on RA

Systemic examination
RS- Bilateral Airway entry present, nvbs
Cvs -S1 S2 Heard
P/A - distended,tenderness + a hard mass of size 12x8 cm palpable in the suprapubic region.
Cns- nad



X RAY ERECT ABDOMEN

ECG

ULTRASOUND ABDOMEN

DIAGNOSIS
UROSEPSIS secondary to b/l hydro ureteronephrosis with Bladder calculi with AKI  with UTI.

TREATMENT
Tab.NITROFURANTOIN 100 MG OD
Tab.OROFER XT  PO OD
Tab. NODOSIS 500 MG PO BD
Tab.SHELCAL PO OD
Tab. LASIX  20 MG PO BD

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