Harika

65 year old male DOA -27/08/2024 DOD -2/9/2024 CKd DURATION -not known DIAGNOSIS  UREMIC ENCEPHALOPATHY    CHRONIC RENAL FAILURE WITH REFRACTORY HYPERKALEMIA  PAROXYSMAL SUPRAVENTRICULAR TACHYCARDIA  HEART FAILURE WITH MID- RANGE EJECTION FRACTION   Clinical Findings  C/O BREATHLESSNESS SINCE 2 DAYS  HOPI: THE PATIENT WAS APPARENTLY ASYMPTOMATIC 1MONTH BACK THEN HAD PEDAL ODEMA ON AND OFF PITTING TYPE BREATHLESSNESS SINCE 2 DAYS, GRADE 3-4 MMRC, NOT RELIIEVED AT REST N/H/O CHEST PAIN, PALPITATIONS, ORTHOPNEA, PND N/H/O PAIN.ABDOMEN, VOMITING, LOOSE STOOLS  PAST HISTORY: K/C/O FILARIASIS SINCE 5 YRS  K/C/O HTN SINCE 6 MONTHS ON UNKNOWN MEDICATIONS PERSONAL HISTORY  APPETITE - NORMAL DIET - MIXED BOWEL AND BLADDER - REGULAR NO KNOWN ALLERGIES AND ADDICTIONS GENERAL EXAMINATION : PAITIENT IS CONSCIOUS,COHERENT,COOPERATIVE. NO SGNS OF PALLOR,ICTERUS,CYNOSIS,CLUBBING,LYMPHADENOPATHY,OEDEMA OF FOOT TEMP: 98.2F BP:90/60MMHG RR: 30 CPM...

47 year old male DOA -7/11/2024 DOD-15/11/2024 Diagnosis CKD SECONDARY TO ?HYPERTENSIVE NEPHROPATHY  K/C/O HTN CHEIF COMPLAINTS: C/O B/L LEGS SWELLING SINCE 1 MONTH  C/O SOB SINCE 1 MONTH COUGH GENERALISED BODY ITCHING ABDOMINAL BLOATING SENSATION  HISTORY OF PRESENTING ILLNESS: PATIENT WAS APPARENTLY ASYMPTOMATIC 1 MONTH AGO , THEN HE DEVELOPED COUGH , NON PRODUCTIVE, A/W SOB GRADE II-III C/O PEDAL EDEMA G-III PITTING TYPE EXTENDING FROM KNEE TO ANKLE C/O FACIAL PUFFINESS, ABDOMINAL BLOATING SENSATION NO C/O HEADAHCE, NAUSEA, VOMITING NO C/ CHEST PAIN , PALPITATIONS,PND NO C/O BURNING MICTURITION,LOOSE STOOLS  PAST HISTORY: K/C/O CKD 6 MONTHS ON MEDICATION  K/C/O HTN 3 YRS N/K/C/O/ ,DM CVA, CAD, TB, EPILEPSY  GENERAL EXAMINATION : PATIENT IS CONSCIOUS ,COHERENT , COPERATIVE NO SIGNS OF PALLOR , ICTERUS, CYANOSIS, CLUBBING, LYMPH ADENOPATHY ,OEDEMA OF FOOT. TEMP: 98.3 PR: 89 BPM RR: 18 CPM BP: 160/80 MMHG SYSTEMIC EXAMINATION: CVS: S1 S2 HEARD. NO MURMURS R...

40year old female  DOA -1/11/2023 DOD -2/12/2023 CKD DURATION -6months and since then was on maintenance hemodialysis  Diagnosis  CKD ON MHD Case History and Clinical Findings C/O PEDAL EDEMA SINCE 6MONTHS,SOB SINCE 3 DAYS  HOPI: PATIENT WAS APPARANTLY ASYMPTOMATIC 6 MONTHS BACK THEN SHE DEVELOPED PEDAL EDEMA WHICH WAS PITTING TYPE,EXTENDING UPTO KNEE JOINT SINCE 3 DAYS.SHE DEVELOPED SHORTNESS OF BREATH WHICH WAS INSIDIOUS IN ONSET ,GRADUALLY PROGRESSIVE PROGRESSED FROM GRADE 2 TO GRADE 4 ,AGGREVATED ON EXERTION ,ORTHOPNEA + NO PND ,NO SEASONAL VARIATION ,NO DIURNAL VARIATION.DECREASED URINE OUTPUT SINCE 3 MONTHS.NO H/O FEVER ,COUGH,VOMITINGS ,LOOSE STOOLS,PAIN ABDOMEN ,GIDDINESS,CHESTPAIN ,PALPITAIONS,EXCESSIVE SWEATING  Past history  CKD ON MHD SINCE 6MONTHS  K/C/O HTN SINCE 4 YRS N/K/C/O CVA,THYROID ,ASTHMA,EPILEPSY O/E: PT IS C/C/C  PR:78 BP:150/80 MMHG  RR:17 SPO2:98% ON RA  CVS:S1 S2 + NO MURMURS  RS:BAE+ NVBS P/A:SOFT NON TEN...

60year old male DOA -5/3/2024 DOD -11/03/2024 CKD DURATION -4years and is on maintenance hemodialysis since 4months DIAGNOSIS  CHRONIC RENAL FAILURE  Case History and Clinical Findings  C/O B/L PEDAL EDEMA SINCE 3MONTHS C/O LOSS OF APPETITE SINCE 1MONTH HOPI:PT WAS APPARENTLY ASYMPTOMATIC 3MONTHS BACK THEN DEVELOPED B/L PEDAL EDEMA WHICH IS INSIDIOUS IN ONSET AND GRADUALLY PROGRESSIVE,PITTING TYPE OF EDEMA UPTO THE KNEES. C/O LOSS OF APPETITE SINCE 1 MONTH NO H/O FEVER,NAUSEA,VOMITING NO H/O ABDOMINAL PAIN,BURNING MICTURITION NO H/O INVOLUNTARY MICTURATION AND DEFECATION NO H/O INVOLUNTARY MOVEMENTS NO H/O SOB,ORTHOPNEA,PND NO H/O BLEEDING MANIFESTATION  PAST HISTORY K/C/O HTN SINCE 1 YEARS (NON COMPLIANT TO DRUGS)  N/K/C/O DM,EPILEPSY,ASTHMA,CAD,CVA AND THYROID DISORDERS  GENERAL EXAMINATION PALLOR PRESENT NO ICTERUS,CYANOSIS,CLUBBING ,LYMPHADENOPATHY OEDEMA OF FEET IS PRESENT  TEMP-98.2 F PR-88BPM BP-150/80 MM HG SPO2 98% @RA CVS - S1S2 HEARD,NO MURM...

64year old male DOA -10/5/2024 DOD -21/5/2024 CKD DURATION -2months and since then was on maintenance hemodialysis  Diagnosis  CKD ON MHD  DIABETIS MELLITUS  HYPERTENSION  Case History and Clinical Findings C/O SOB SINCE 3 MONTHS HOPI  PATIENT WAS AP[PARENTLY ASYMOTOMATIC 3 MONTHS AGO THEN HE DEVELOPE SOB OF GRADE 2 TO 3 NOT ASSOCIAED WITH COUGH PALPITATION CHEST PAN PROFUSE SWEATING NO H/O DECREASED URINE OUTPUT H/O NSAID ABUSE + NO H/O HEMATURIA,PYURIA,CHYLURIA  PAST ILLNES H/O HTN SINCE 2 YEARS H/O DM2 SINCE 10 YEARS ON REGULAR MEDICATIONS N/K/C/O CVA CAD TB EPILEPSY .  GENERAL EXAMINATION: ON EXAMINATION PALLOR-PRESENT NO CYANOSIS CLUBBING ICTERUS LYMPHADENOPATHY OEDEMA  VITALS: TEMP:98F  PR-90/MIN RR-20/MIN BP-130/80 MMHG SPO2-98% SYSTEMIC EXAMINATION: CNS-NFND CVS-NO THRILLS,NO MURMURS,S1S2 HEARD RS-DYSPNOEA IS PRESENT NO WHEEZE TRACHEA -CENTRAL P/A-SOFT NT Investigation CBP HB- 8GM/DL MCV -85.4 MCH -29.4 MCHC -32.9 TC- 11000CELLS/...

58 year old male  DOA -26/08/2024 DOD -23/09/24 CKD DURATION -not known  On maintenance hemodialysis since 8months  DIAGNOSIS  CKD ON MHD HYPERTENSION  CHEIF COMPLAINTS : C/O PEDAL EDEMA SINCE 1 MONTH C/O SOB SINCE 1 MONTH HOPI: PATIENT WAS APPARENTLY ALRIGHT 1 MONTH BACK THE HE HAD PEDAL EDEMA SINCE 1 MONTH WHICH IS PITTING TYPE TILL KNEE. SOB SINCE 1 MONTH MMRC GRADE-2, RELIVED BY TAKING REST. NO ORTHOPNEA NO PND PAST HISTORY: K/C/O HTN  N/K/C/O , DM, CAD, CVA, SEIZURES. PERSONAL HISTORY  APPETITE - NORMAL  DIET - MIXED BOWEL AND BLADDER - REGULAR  NO KNOWN ALLERGIES ADDICTIONS- NONE GENERAL EXAMINATION : PALLOR PRESENT, PEDAL EDEMA PRESENT CLUBBING OF FINGURE PRESENT NO SIGNS OF ICTERUS,CYNOSIS,LYMPHADENOPATHY TEMP: 97.8F BP:130/80 MMHG RR: 18 CPM PR: 97BPM SPO2 98 AT RA SYSTEMIC EXAMINATION: CVS: S1S2 HEARD. NO MURMURS. RS: BAE+. TRACHEA- CENTRAL, B/L BASAL CREPTS PRESENT P/A: SOFT,NON-TENDER. CNS: NFND Investigation HB -9.5 MCV -87.8 MCH...

45year old male  DOA -1/10/2024 DOD -7/10/2024. CKD DURATION -3years and is on maintenance hemodialysis since 7months  Diagnosis  CKD[STAGE V]  DELIRIUM UNDER EVALUATION(?UREMIC)- MODERATE ANEMIA SECONDARY TO CKD K/C/O DM II,l HTN,CKD  S/P 2 PRBC TRANSFUSIONS  Case History and Clinical Findings  C/O DECREASED URINE OUTPUT SINCE 4 DAYS  C/O VOMITINGS SINCE TODAY MORNING  HOPI PATIENT WAS APPARENTLY ASYMPTOMATIC 4 DAYS AGO THEN DEVELOPED DECREASED URINE OUTPUT INSIDIOUS IN ONSET GRADUALLY PROGRESSIVE NOT ASSOCIATED WITH BURNING MICTURITION NAUSEA AND GENERALISED WEAKNESS H/O VOMITINGS NON BILIOUS NON PROJECTILE FOOD AS CONTENT N/H/O FEVER COLD , COUGH, ALLERGIES N/H/O ABDOMINAL PAIN , DIARRHOEA N/H/O CHEST PAIN , PALPITATIONS , SWEATING, SOB  PAST H/O K/C/O HTN ,DM2,CKD SINCE 3 YEARS ON MEDICATION.  N/K/C/O , EPILEPSY, THYROID ABNORMALITIES, ASTHMA , TB , CAD, CVA PERSONAL HISTORY APPETITE - NORMAL DIET - MIXED BOWEL AND BLADDER - REG...