54year

54year old male
DOA -10/6/2023
DOD -3/8/2023
CKD DURATION -2years
And on maintenance hemodialysis since then.

Diagnosis 
CKD ON MHD


Case History and Clinical Findings

C/O B/L PEDAL EDEMA SINCE 1WEEK &C/O DECREASED URINE OUTPUT SINCE1WEEK

 HOPI :
PATIENT WAS APPARENTLY ASYMPTOMATIC 2YRSBACK THEN HEDEVELOPED PAIN ABDOMEN FOR WHICH HE WENT TO HOSPITAL &FOUND TO HAVEHIGH BLOOD PRESSURE. HE ALSO HAD B/L PEDAL EDEMA ,PITTING TYPE , EXTENDING UP TO KNEE , INSIDIOUS ONSET A/W DRCREASEDURINE OUT PUT NO H/O COLD, COUGH, FEVER, BURNING MICTURITION NO H/O CHEST PAIN, PALPITATIONS, SOB, ORTHOPNEA


 PAST HISTORY :
K/C/O HTN SINCE2YEARS N/K/C/O DM,ASTHMA, TB, CAD,CVD PERSONAL HISTORY : DIET -MIXED
APPETITE-NORMAL B&B-REGULAR SLEEP-ADEQUATE GENERAL EXAMINATION
NO PALLOR, ICTERUS CLUBBING CYANOSIS LYMPHADENOPATHY EDEMA TEMP -AFEBRILE PR - 86 BPM
RR-16CPM
BP - 160/80 MMHG
CVS S1S2+
RS NVBS
PA - SOFT AND NON TENDER
CNS NFND
Investigation

HB -8.6
MCV -90.2
MCH -23.6
MCHC -31.6
TLC -7700
PLT -2.29

S IRON -55.5
S FERRITIN -265.4



UREA- 126
CREAT -9.6
Na +-138
K+ 4.0
Cl- 99


USG ABDOMEN
GRADE III RPD CHANGES IN LEFT KIDNEY
GRADE III RPD CHANGES IN RIGHT KIDNEY
B/L SUBCENTRIC SIMPLE RENAL CORTICAL CYSTS
ECG-NORMAL SINUS RHYTHM
2D ECHO


MILD CONCENTRIC LVH
NO MR/TR/, NO AS/MS
EF 62%
GOOD LV SYSTOLIC FUNCTION
NO DIASTOLIC DYSFUNCTION

INTERVENTIONS
ORAL IRON THERAPY -DAILY TAB.OROFER XT
IV IRON THERAPY -TWICE /WEEK
EPO -YES
EPO DOSING -ONCE/WEEKS
PRBC TRANSFUSED -0
ADMISSION IN ICU -0

Treatment Given(Enter only Generic Name)
TAB NICARDIA 20MG PO/TID
TAB OROFER XT PO/OD
TAB SHELCAL CT PO/OD
TAB.LASIX 80MG PO/BD
TAB. TELMA 40 PO/OD
TAB. METAPROLOL 25MG PO/OD
TAB. ARKAMINE 0.1MG PO/TID
INJ. IRON SUCROSE 100MG IV ONCE WEEKLY
INJ. EPO 4000 IU SC ONCE IN 2 WEEKS

Advice at Discharge
TAB NICARDIA 20MG PO/TID
TAB OROFER XT PO/OD
TAB SHELCAL CT PO/OD
TAB.LASIX 80MG PO/BD
TAB. TELMA 40 PO/OD
TAB. METAPROLOL 25MG PO/OD 
TAB. ARKAMINE 0.1MG PO/TID
INJ. IRON SUCROSE 100MG IV ONCE WEEKLY INJ. EPO 4000 IU SC ONCE IN 2 WEEKS


Follow up at 3months 
HB -9.3
MCV -90 .1
MCH -33.1
MCHC -30.3
TLC -6700
Plt-3.2


Follow up the end of thesis 
HB -8 .4
MCV -87.1
MCH -30.2
MCHC -29.4
TLC -7700
PLT -3.1

Comments

Post a Comment

Popular posts from this blog

THESIS- 50CASES THEMATIC ANALYSIS

TITLE - OUTCOMES OF ANEMIA IN PATIENTS OF CHRONIC KIDNEY DISEASE  Coding: identify initial codes and labels to capture the key concepts and ideas. Categorization: group the codes into categories and subcategories to organize the data. Theme identification: identify the emerging themes and patterns in the data. Theme representation: present the theme as new learning points highlighting the key findings and insights related to the outcomes of anemia in patients of chronic kidney disease by mentioning the laboratory values  2)access the interventions for Anemia and compare with the kdigo guidelines  3)To access and mention the factors influencing the outcomes of anemia in patients of chronic kidney disease  4) summarize the final outcome CASE 1 [5/4, 19:32] Harika: Case 1 -86 year old female Date of admission -27/02/24 Date of discharge-4/3/24 DIAGNOSIS  CHRONIC RENAL FAILURE SECONDARY TO DIABETIC NEPHROPATHY LEFT DISTAL TIBIA PLATING WITHOUT DNVD  K/C/O DIABE...
Read more

THESIS

TITLE -OUTCOMES OF ANEMIA IN PATIENTS OF CHRONIC KIDNEY DISEASE.     INTRODUCTION -          Anemia is a major complication affecting chronic kidney disease patients accounting to increased cardiovascular diseases ,decreased appetite with progressive malnutrition and major cause for poor outcomes including    higher rates of mortality. AIM - To evaluate outcomes of anemia in patients with chronic kidney disease OBJECTIVES 1. To assess the haemotological profile and serum iron indices in chronic kidney disease. 2. To assess therapeutic uncertanities in managing patients with anemia of chronic renal failure.  3. To assess the outcomes in terms of mortality. TYPE OF ATUDY DESIGN - Prospective Observational Qualitative study INCLUSION CRITERIA  1.Hb <13mg/dl in men and Hb < 12mg/dl in women. 2. Greater than 18 Years age of both genders. 3.GFR <60 ml/min/1.73sq.mts >3months. 4. Informed Consent from each pat...
Read more

37year old female

DOA-21/08/2024 DOD-19/09/2024 DIAGNOSIS  CKD ON MHD K/C/O DM II 10 YEARS K/C/O HTN SINCE 4 YEARS  CHIEF COMPLAINTS C/O PEDAL EDEMA SINCE 1 MONTH C/O BURNING MICTURITION SINCE 1 MONTH  HOPI PATIENT WAS APPARENTLY ASYMPTOMATIC 1 MONTH AGO THEN SHE DEVELOPED PEDAL EDEMA SINCE 1 MONTH PITTING TYPE , EXTENDING UPTO KNEE BURNING MICTURITION SINCE 1 MONTH NO WHITISH DISCHARGE, NON BLOOD STAINED NO H/O FEVR , COL, COUGH, ALLERGIES NO H/O ABDOMINAL PAIN NO H/O VOMITING , NAUSEA, LOOSE STOOLS  PAST HISTORY K/C/O DM II SINCE 10 YEARS ON INJ HAI SC 20 U -O-20U AND TAB.GLICLEZIDE 60 MG PO BD K/C/O HTN SINCE 4 YEARS ON TAB CINOD 10 MG PO BD N/K/C/O , TB , ASTHMA, THYROID ABNORMALITIES, CAD, CVA H/O CARCINOMA LEFT BREAST OPERATED ON 26 / 3 /21 AND CHEMOTHERAPY 4 YEARS BACK PERSONAL HISTORY  APPETITE - NORMAL DIET - MIXED BOWEL AND BLADDER - DECREASED URINE OUTPUT NO KNOWN ALLERGIES ADDICTIONS- TOBACCO GENERAL EXAMINATION : PATIENT IS CONSCIOUS,COHERENT,COOPERATIVE. NO SIGNS OF...
Read more