45 YEAR OLD WITH PEDAL EDEMA
A 45 year old female, cook by occupation, mother of two, came to the OPD on with chief complaints of loss of appetite and vomiting since 2 months
Pedal edema since 1 year
No c/o Shortness of breath, decreased urine output, burning micturition.
The patient was apparently asymptomatic 1 year ago then she developed pedal edema, on and off, upto mid calf level ,which relieved on walking.
C/o facial puffiness on and off since 1 year
The pt went to a hospital in Nalgonda for the same where her Sr.creat was 11.0
The pt was advised for dialysis I/v/o high serum creatinine but they were not willing to get it done and so was started on medication after which her serum creatinine came down to 7.
The pt has been using the same medication since the past one year with which she was comfortable as her complaints subsided and was leading a normal life.
Since 2 months ago she developed loss of appetite and vomiting for which she went to a private hospital.
She was referred to KIMS, NKP for dialysis I/v/o high serum creatinine.
Patient is a k/c/o Hypertension since 1 year, on medication.
Not a k/c/o DM, TB, Asthma, Epilepsy
Vitals:
Temp- 98.6F
BP- 140/80 mmhg
PR- 86 bpm
RR- 17 cpm
Spo2- 99% at RA
GRBS- 94 mg/dl
General Examination:
Patient is conscious/coherent/cooperative
Moderately built and well nourished
Pallor +
Icterus -
Cyanosis -
Koilonychia -
Lymphadenopathy-
Pedal edema + upto ankle
CVS- S1 S2 + No murmurs
RS- BAE+ No added sounds
P/A- Soft, Non tender
CNS- NAD
USG:
Findings: B/L grade III RPD Changes
Diagnosis:
?Hypertensive Nephropathy
Investigations:
Hb- 7.5
Na-140
K-4.4
Cl-101
Serum creatinine- 14.6
Urea- 194
Treatment:
Tab Lasix 40 mg BD
Tab Nicardia 10 mg BD
Tab Orofer XT OD
Tab Nodosis 500 mg OD
Tab Shelcal CT OD
Fluid and Salt restriction
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