52F ACUTE PULMONARY EDEMA CHRONIC RENAL FAILURE HTN 1MONTH DM2 5YRS
Diagnosis -ACUTE PULMONARY EDEMA CHRONIC RENAL FAILURE HYPERTENSION SINCE 1MONTH DIABETES MELLITUS SINCE 5YEARS CC -C/O FACIAL PUFFINESS AND PEDAL EDEMA SINCE IMONTH HOPIS PATIENT WAS APPARENTLY ASYMPTOMATIC 1 MONTH AGO THEN SHE DEVELOPED FACIALPUFFINESS AND PEDAL EDEMA SINCE I MONTH INSIDIOUS ONSET GRADUALLY PROGRESSIVE WITH SOB GRADE III FOR WHICH SHE USED OUTSIDE MEDICATION AND PARTIALLY RELIVED. DECREASED URINE OUTPUT SINCE 2DAYS FEVER SINCE 2DAYS NOT ASSOCIATED WITH CHILLS AND RIGORS,NO DIURNAL VARIATION. COUGH NOT ASSOCIATED WITH EXPECTORATION . PAST HISTORY - DIABETES MELLITUS SINCE 5YEARS. HYPERTENSION SINCE 1MONTH NO OTHER COMORBIDITIES GENERAL EXAMINATION PT IS C/C/C BP-140/80MMHG PR-86BPM SPO2-99 % on RA RR-18CPM SYSTEMIC EXAMINATION CVS-S1S2+,NO MURMURS RS -BAE +, BILATERAL DIFFUSE CREPTS + IN ALL REGIONS INVESTIGATIONS RFT -4/01/2024 UREA 158 CREAT 6.6 NA + 133 K+. 5.3 CL- 101 HEMOGRAM HAEMOGLOBIN 9.9 gm/dl TOTAL COUNT 16,100 cells/...