A 75 year old man with pedal edema,loss of appetite,Nausea and Vomiting

70 year old male resident of muppara Came to the opd with complaint of restlessness; vomiting and loss of appetite 


HOPI


Patient is apparently asymptomatic 4 years back then he developed decreased urine output and was diagnosed with CKD and was on medication 


15 days back he collapsed while walking and taken to RMP his BP then was 220mmhg and pulse was 50 beats per minute


Then he was taken to a private hospital in suryapet and was given a injection?


DAILY ROUTINE:


 He wakes up at 6 AM and freshens up. He has breakfast at around 9 am and then rests for some time. He has lunch at 1 pm and rests for an hour. In the evenings he spends time with his family or by himself or chats with the neighbors. He takes dinner at 8 pm and goes to bed. 


PAST HISTORY:

Pt is a K/C/O HTN since 25yrs and DM2 since 8yrs

Pt is not a K/C/O TB,asthma, epilepsy,thyroid disorders.

PERSONAL HISTORY: 


Diet-Mixed


Appetite-Normal


B and B movements- Regular


Sleep- Regular


No addictions


TREATMENT HISTORY: pt is on antihypertensives and Oral hyperglycemic agents.


FAMILY AND ALLERGIC HISTORY: No relevant history 




GENERAL EXAMINATION: 


Patient was conscious, cooperative,well oriented to time,place , person.Moderately nourished and well built


PALLOR WAS PRESENT


NO CYANOSIS


NO ICTERUS


NO CLUBBING


NO GENERALISED LYMPHADENOPATHY


PEDAL EDEMA PRESENT (Pitting type)




VITALS::


TEMP AFEBRILE


PR 88 bpm


RR 14cpm


BP 



Systemic Examination:

Abdomen: Soft and non tender. Bowel sounds heard 

Cardiovascular system: S1,S2 heard 

Central nervous system: No focal neurological deficits.

Respiratory system: Bilateral Air entry present. NVBS Breath sounds heard all over the chest. Trachea is Central .


INVESTIGATIONS:










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