48 year old female patient with pedal edema
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CHEIF COMPLAINT:
A 48 yr old female patient came to the causality with cheif complaint of pedal edema since 1 yr and puffiness of face since 2 months.
History of present illness:
Patient was apparently asymptomatic 1 year back then she developed bilateral pedal edema extending upto knee, which is pitting type.she also noticed puffiness of face since 2 months and it reduced after taking medication and started from 1 week.
History of past illness:
Known complaint of hypertension since 3 years ( on regular medication TAB . NICARDIA 20mg POBD)
Known complaint of hypothyroidism since 1 year( on T THYROXINE 50mg POBD)
No known history of diabetes, tuberculosis,asthma , epilepsy.
PERSONAL HISTORY:
Diet mixed
appatite normal
Sleep adequate
Bowel and bladder movements normal
Micturation normal
No pernicious habits
PHYSICAL EXAMINATION:
Pallor yes
Cyanosis no
Icterus no clubbing of fingers no
Lymphadenopathy normal
Malnutrition no
Dehydration no
Temperature 98.9c
Pulse rate 99/ min
Respiratory rate 20/ min
Blood pressure 150/ 90 mmHg
Spo2 100
SYSTEMIC EXAMINATION
CVS: thrills no
Cardiac sounds s1 s2
Respiratory system:
Position of trachea center
Dysponea yes
Wheeze no
Abdominal examination:
Shape scaphoid
No palapable masses
No tenderness
Liver not palpable
Spleen not palpable
Bowel sounds present
PROVISIONAL DIAGNOSIS: CRF
Plan of care hemodialysis
INVESTIGATIONS:
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