General medicine

Hi ,I'm Rama Krishna Dega 3rd semester medical student.this is an elog book to  discuss our patients health deta after taking this consent. This also reflects my patient centered online learning portfolio

CASE SHEET:

  78 year old female patient presented with reduced urine output & generalised swelling

78 year old female farmer from Miryalguda was admitted into the hospital on 11-07-2022. 

Chief complaints:

78 year old female was admitted into the hospital with cheif complaints of swelling of left lower limb since 4 days, blister on left lower limb since 3 days & decreased urine output since 4 days. 

History of present illness:

Patient was apparently asymptomatic 4 days back & then she had severe itching due to mosquito bite, following which, she scratched that which resulted in bleeding & she used hot water to clean that area & she noticed blister on left lower limb 3 days back. She also developed bilateral pitting type of pedal edema of both the lower limbs & associated with local rise in temperature of both lower limbs. And decreased urine output since 4 days

SOB present 

No history of fever 

No history of Vomitings

No history of diabetes 

No history of HTN.

No history of allergies 


Past history:

She had undergone with hysterectomy

N|K|C|O HTN, DM, epilepsy, asthma, TB


Family history:

Not relevant

Drug history:

Nil


Personal history:

Diet : Mixed

Appetite : normal

Sleep: Adequate 

Addictions : Nil

Bowel/ bladder: regular bowel movements/ decreased urine output

Allergies: nil


General examination:

Consious coherent cooperative 

Moderately built

Moderately nourished 

No pallor  

No Icterus  

No Cyanosis 

No clubbing of finger 

No lymphadenopathy

Pedal edema present - bilateral pitting type


Vitals:

Temperature - 98.6 F

Pulse rate - 88 /min

Respiratory rate - 16/min

Blood pressure- 110/70 mm Hg

SpO2 - 98%

GRBS - 106 mg/dl


Systemic Examination:

A. Cardiovascular system - 

No thrills

No cardiac murmurs

Cardiac sounds: S1 & S2

B. Respiratory system -

No dyspnea

No wheezing

Vesicular breathe sounds

C. Abdomen -

Obese 

No tenderness

No palpable mass


Reports:









When she came to casualt:


After 3 days of dressing :





Provisional diagnosis :

Chronic renal failure                                                                                                  

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