CKD ON MUD

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22 Oct 2021

Venkata Meghana Badam

Roll no -146 , 3rd sem 

This is an online e-log platform to discuss case scenarios of a patient with their guardian's permission.

I have been given this case to solve in an attempt to understand the topic of patient clinical data analysis to develop my competency in reading and comprehending clinical data including, history, clinical findings, investigations, and come up with a diagnosis and treatment plan. 

CHIEF COMPLAINTS:

The pt with 32 yr old male came to OPD with c/o pedal edema since 1 month and decreased urine output since 10 days k/c/o CKD on MUD

HISTORY OF PRESENTING ILLNESS:

The pt was apparently asymptomatic 1 month ago, he noticed pedal edema and decrease in UO since 10 days.

 He is on dialysis since 8 months

 He went to local hospital with increased BP and on examinations he was diagnosed with kidney disease.From then he is on dialysis 

HISTORY OF PAST ILLNESS:

 K/c/o HTN since 1yr

TREATMENT HISTORY:

He used tablet for hypertension since 1 year

PERSONAL HISTORY

Married

Autodriver

Decreased appetite

Non vegetarian

Bowels- regular

Micturition- decreased

No k/c/o known allergies

Alcohol- teetotaler

FAMILY HISTORY:

No relevant family history

GENERAL EXAMINATIONS

No No -pallor/Icterus/Cyanosis/Clubbing/Lymphadenopathy/Malnutrition

Edema is seen

Temp- 98.6 F

Pulse rate - 92/min

 RR- 24/ min

 Bp 130/80 mm/Hg

SpO2 - 98 percentage

GRBS - 126md/ dl

SYSTEMIC EXAMINATION

CVS:

No thrills

S1 S2 heard

No murmurs 

RESPIRATORY SYSTEM:

Dyspnoea: yes

Wheeze:no

Position of trachea: central

Breath sounds: vesicular

Adventitious sounds: not heard

ABDOMEN:

Shape:scaphoid

No tenderness

No palpable mass 

No hernia

No free fluid

No bruits

Liver n spleen: not palpable

Bowel sounds : yes

Genitals n PV examination n P/R examination : NAD

CNS:

Alert/conscious

Speech: normal

No meningeal irritation

No cerebral signs

Normal gait

INVESTIGATIONS:







ULTRA SOUND




PROVISIONAL DIAGNOSIS:

CKD on MUD

TREATMENT:

Fliud restriction <1.5lts/day

Salt restriction <2gms/day

INJ Pantop 40 mg IU/OD

TAB OROFER XT PO/BD

INJ Iron Sulfate 1Amp

CN 50 ml NS/IV weekly once

TAB Nodosis 500 mg PO/OD

 TAB NICARDIA 20 mg PO/TID

TAB SHELCAL LT PO/OD

MONITOR VITALS 4 th hourly

INJ ERYTHROPOIETIN 4000 Units weekly once

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