CASE

 30yr old female(k/c/o of CKD on MHD) came with the complainants of SOB ,facial puffiness and pedal edema (bilaterally) since 2days and also C/O chest pain which is nonradiating retrosternal.
 
Pt was asymptomatic 3months back 
5yrs back pt was diagnosed with HTN.
6months back pt was diagnosed with kidney problem.
3months back hemodialysis was started to the patient.
2days back patient felt nausea , diarrhea, urination has stopped and experienced SOB.

K/C/O:  HTN
N/K/C/O DM,ASTHMA ,CVD,IHD,TB , EPILEPSY, THYROID DISORDERS.

VITALS;
Temp: 98.3 F
PR :  92/min
BP: 110/80
SPO2:98%
GRBS:104mg %

PHYSICAL EXAMINATION;
CVS;
S1 AND S2 are heard

RESPIRATORY SYSTEM ;

BAE +
ABDOMEN
SHAPE - SCAPHOID
NO TENDERNESS
NO PALPABLE MASS
LIVER and SPLEEN are not palpable
BOWEL SOUNDS are present
CNS;
pt is CONSCIOUS
speech is NORMAL
REFLEXES;
      BICEPS TRICEPS SUPINATOR KNEE ANKLE 
RT.  ++.       ++.        ++.          ++.     ++
LT.  ++.       ++.        ++.          ++.     ++
PROVISIONAL DIAGNOSIS;
CKD
INVESTIGATIONS ____



 

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