1601006022 Short case

52 year old male farmer my occupation presented to the opd with chief complaint of 

  • Bilateral swelling in lower limbs since 3 days


The patient was apparently asymptomatic 1 week back then he developed bilateral swelling over legs since 1 week is which started near the foot and gradually progressed to the knee. It was pitting type which resolved in between and again started 3 days back.

He had similar complaints in the past for which he went to a local hospital and was advised on taking salt and water restricted diet.

Medication:

 telmesartan for hypertension since 2 years.

 Addictions :He is a chronic alcoholic and smoker.


Examination :

Bilateral pedal edema pitting type found till knee on general examination.

Respiratory system : Bilateral air entry present and normal vesicular breath sounds heard.

CVS examination : No thrills, s1 s2 heard, no murmurs.

Abdomen examination : no hepatomegaly or splenomegaly.

No positive findings found other than edema.


Investigations :

RFT


Hemogram 


LFT 



PROVISIONAL DIAGNOSIS :

Chronic renal failure


TREATMENT :

Salt and fluid restriction (<1gm/day <1 lit/day)

Inj. Lasix 40mg

Tab. Nicardia 

Tab. Orofer

Inj. Erythropoietin

Tab. Shelcal


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