CKD ON MHD

This is an online e log book to discuss our patient de-identified health data shared after taking his / her / guardians signed informed consent. Here we discuss our individual patients problems through series of inputs from available global online community of experts with an aim to solve those patients clinical problem with collective current best evident based input.

This E blog also reflects my patient centered online learning portfolio and your valuable inputs on the comment box is welcome.
A  35 year old male came to opd with a cheif complaint of
 decreased appetite since 15 days
Vomiting since 15 days
Bilateral pedal edema since 15days
Shortness of breath since 5days 

HOPI-
patient was apparently asymptomatic 1 and half year ago then he had symptoms of decreased appetite went to hospital then they diagnosed as kidney disease and he used medication for 1 month and stopped later after six months he developed shortness of breath and bilateral pedal edema then he opted for dialysis then after 1year came with symptoms of decreased appetite with vomiting from past 15days 2 episode per day which is insidious in onset non bilious ,non projectile contain food particles
He had h/o bilateral pedal edma which is pitting type from past 15days
H/o shortness of breath of grade -0 to grade 2
PAST HISTORY:
K/C/O -HTN SINCE 1YR ON TAB.CLINIDIPINE
h/o kidney disease i.e ckd since 2yr  on dialysis sincee 

Personal history 
Diet - mixed
Appetite decreased since 1month
Bowel and bladder -regular
Sleep -regular
Addiction - occasionally alcholic stopped 1year back

FAMILY HISTORY
Not significant

Treatment history
On antihypertensive since 1 year

General examination 
Patient is comcious, coherent, Cooperative
No h/ o pallor,icterus, cyanosis, lymphadenopathy 
H/o oedema of feet

Vital 
Temperature 99.2f
Bp 170/100 mm Hg
Pr 97bpm
Rr 20cpm
Spo2 99%
Grbs 115

Systemic examination 
Cvs s1 s2 heard ,no murmur 
Rs- BAE present
Cns- Nfnd
P/a soft ,non tender

Investigation
Cxr
Usg
ecg
complete bloood picture 
renal function test 
blood grouping 
serology
provisional diagnosis
CKD ON MHD

TREATMENT
Tab.lasix 40 mh po bd
Tab nicardia 10 mg po tid
Tab.nodosis 500 mg po bd




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