70 YEAR OLD MALE PT WITH GENERALISED EDEMA




C/O FACIAL PUFFINESS SINCE 1 MONTH

C/O DISTENSION OF ABDOMEN SINCE 1 MONTH

SWELLING OF LEFT LOWER AND RIGHT UPPER LIMB SINCE 1 MONTH

H/O FEVER 1 MONTH BACK (SUBSIDED WITH MEDICATION)

HOPI:

PATIENT WAS APPARENTLY ASYMPTOMATIC 10 YEAR BACK, THEN HE DEVELOPED DIFFICULTY AND PAIN DURING WALKING (H/O TRAUMA IN CHILDHOOD) FOLLOWING WHICH PATIENT DEVELOPED DEFORMITY OF KNEES AND WAS SUGGESTED SURGERY FOR THE SAME AND WAS BEDRIDDEN FROM THEN(WALK WITH SUPPORT)

5YEARS BACK HE HAD FACIAL PUFFINESS, DISTENSION OF ABDOMEN, SWELLING OF LIMBS, FEVER, SOB, DECREASED URINE OUTPUT, DECREASED BOWEL MOVEMENTS AND DIAGNOSED TO HAVE? PNEUMONIA AND RENAL FAILURE AND STARTED CONSERVATIVE MANAGEMENT AND RESOLVED.

2019-H/O SIMILAR COMPLAINT AND GOT ADMITTED FOR 1 WEEK AND TREATED CONSERVATIVELY

1 MONTH BACK COMPLAINTS OF FEVER, SOB. FEVER FOR 2 DAYS, INTERMITTENT, LOW GRADE, CHILLS+, RIGORS-, LOOSE STOOLS -,NO VOMITING.

SOB OF GRADE II (MMRC) COUGH PRESENT. COLD PRESENT SUBSIDED AFTER 3 DAYS. NO H/O PND, ORTHOPNEA.

GENERALIZED SWELLING (ANASARCA) PRESENT SINCE 1 MONTH BACK AND SLIGHTLY DECREASE AFTER 2 WEEKS AFTER INTAKE OF MEDICATION

PALPITATIONS PRESENT, DECREASED URINE OUTPUT, NO H/O FREQUENCY, URGENCY, HESITANCY 

K/C/O HTN SINCE 3 YEARS (UNDER TAB. TELMA 20 MG PO/OD)

N/K/C/O DM , ASTHMA, TB, EPILEPSY





DIAGNOSIS: ANASARCA UNDER EVALUATION SECONDARY TO HEART FAILURE? RENAL FAILURE

ANEMIA UNDER EVALUATION (NCNC) SECONDARY TO? ANEMIA OF CHRONIC DISEASE WITH TYPE I RESPIRATORY FAILURE SECONDARY TO? 

WITH GRADE II PROSTRATOMEGALY 

HTN+SINCE 3 YEARS 


TREATMENT

 INJ. LASIX 40 MG/IV/STAT (IF BP GRATER THAN 110/70MM HG) 

O2 SUPPLEMENTATION TO MAINTAIN SAT MORE THAN 94%

MONITOR VITALS 2ND HOURLY 

INFORM SOS


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