A 24/M WITH HYDROURETRONEPHROS AND COGNITIVE IMPAIRMENT CBBLE UDHC SIMILAR CASES

 

This is an online E log book to discuss our patient's de-identified health data shared after taking his/her/guardian's signed informed consent. Here we discuss our individual patient's problems through series of inputs from available global online community of experts with an aim to solve those patient's clinical problems with collective current best evidence based inputs. This E log book also reflects my patient-centered online learning portfolio and your valuable inputs on the comment box

 Chief complaints

24 year old male who is a labourer , came with chief complaints of 

Decreased urine output since 10 days

Shortness of breath since 10 days 

Pedal edema since 10 days 

Fever since 10 days 


History of presenting illness

patient was apparently asymptomatic 3  years back. Then he developed decreased urine output for which he went to local hospital and scan was done which revealed hydronephrosis .10 days back he had a trauma to the left little finger and dorsum of right foot for which he went to local hospital and dressing was done .10 days back he developed shortness  of breath which was insidious in onset and gradually progressive (grade 4 ) aggravated on walking relieved on medication .

Pedal edema since 10 days which was extending till ankle 

Fever since 10 days which was continous , not associated with chills and rigour  

I/v/o increased serum creatinine dailysis was initiated yesterday

 

PAST HISTORY:

Not a K/c/o  DM , HTN , asthma , epilepsy , BA , TB ,CAD

No past surgical history 

No previous blood transfusions


O/E:

Patient is Consious , coherent and co-operative 

Afebrile

BP:130/80 mm hg 

PR ; 88bpm regular

CVS :

NO engorged veins, no visible apex beat

JVP normal 

Apex beat 6th intercostal space 1 cm lateral to mid clavivcullar line, S1 S2 +

RS : BAE +, NVBS

P/A: soft , non tender

 

 

 

 

 

 

  

 


 

 


 


ECG


RFT:

Blood urea: 175 mg/dl

Serum creatinine : 9.3 mg/dl

Sodium : 144 meq/l

Potassium :3.6 meq/l

Chloride:106 meq/ l

 

ABG:

PH :7.3mmhg

Pco2:7.8mm hg

Po2:123 mmhg

St. Hco3:

 

Arterial doppler left limb

 

 

No critical stenosis in left upper limb


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