44 yr male with CKD,CAD and hypertension

23/08/2022

 Eblog4

Hi, I am shaik karishma , 3rd Sem Medical Student.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 is welcome.”

I've 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:

A 44 yr old male came was admitted in the hospital on 28/07/2022 with complaints of shortness of breathe,orthopnea, PND(paroxysomal nocturnal dyspnea), and decreased urine output since one month. 


HISTORY OF PRESENT ILLNESS :

He was apparently asymptomatic one month ago and developed shortness of breathe grade '4 , orthopnea and decreased urine output.

PAST ILLNESS:

Post CPR status revived 

DM since 15 years

Hypertension since 3 years

EXAMINATIONS:

Pallor - yes


No icterus 

No cyanosis 

Oedema present



No lymphadenopathy 

No malnutrition 

No dehydration 

VITAL SIGNS 

GRBS 160 mg %

Heart rate 88bpm

Respiration 14 per minute 

BP 110/70 mm of hg 

SpO2 98% 

Treatment history: 

DM present 

CAD present 

Hypertension present 

No asthma 

No tuberculosis

No antibiotics

No hormones 

No chemoradiation 

No blood transfusion

No surgeries 

PERSONAL HISTORY:

married 

Appetite is normal 

Mixed diet 

Bowels are regular 

Decreased micturition 

No known allergies 

No addictions 

FAMILY HISTORY

no DM 

No hypertension 

No heart disease 

No stroke 

No cancer

No tuberculosis 

No asthma 

No hereditory disease 

No psychiatrist illness 

No sibling history 

SYSTEMIC EXAMINATION 

CVS

No thrills 

S1 S2 present 

No cardiac murmurs 

RESPIRATORY

Dyspnea present

Centrally placed trachea 

No wheezing 

Vesicular breathe sounds 

ABDOMEN 

scaphoid shaped abdomen 

Tenderness is not seen 

No palpable mass

Normal hernial orifice

No free fluid 

No bruits 

Liver is not palpable 

Spleen not palpable 

Bowel sound are present

CNS

conscious 

Normal speech 

No neck stiffness seen 

No kernings sign 

Cranial nerves are normal 

Motor system normal 

Sensory system normal 

Glassgow normal

Reflexes are present 

Cerebral signs: no finger nose in-cordination 

No knee heal cordination 

Normal gait 

Other information: 


22/08/22

 he had fever spike since morning 

Vitals 

BP 160/90mmhg 

Pulse 98 per minute 

s1 s2 present 

BAE present 

Per abdomen soft 

CNS = NFND

23/08/2022  He had no fever 



INVESTIGATIONS 















 ECG ON 27/07/2022

21/08/2022 at 5:33 am

21/08/2022 at 14:57 pm


21/08/2022 at 17:44 pm

22/08/2022


DIAGNOSIS: 
CKD 
CAD 
Tachycardia 
Abnormal ST segments and short PR interval

MEDICATION :







24/08/2022
Investigations 

25/08/2022

At 6:00 pm the patient was taken for dialysis
(10th time)
26/08/2022














 




Comments

Popular posts from this blog

55/M Pyrexia under evaluation with cervical laminectomy

46 year old male working in welding shop came for hemodiallysis

A 36 YEAR OLD MALE CAME TO OPD WITH CHIEF COMPLAINS OF WEAKNESS IN BOTH UPPER AND LOWER LIMBS