55YEAR OLD FEMALE WITH B/L PEDAL EDEMA AND SOB

25/4/2022

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55 year old female patient residing in devarakonda came with c/o
- bilateral pedal edema extending from below knee to ankles once 2months
- sob since 2months
She is a k/c/o chronic renal failure since 2months

History of present illness :
Patient was apparently asymptomatic 2months back then she developed bilateral pedal edema, pitting type
SOB on exertion (grade 2/3)

Past history :
K/c/o diabetes mellitus since 10years (not on medication since 2months due to symptoms of hypoglycaemia)
Not a k/c/o hypertension, TB, asthma, epilepsy

Personal history :
Diet - mixed
Appetite - normal
Sleep - adequate

General examination :
Patient is conscious, coherent, cooperative
BP - 140/60mm hg
PR - 84bpm
RR - 21cpm
Spo2 - 98% on RA

Systemic examination :
CVS - S1S2 +
RS - BAE +
P/A - soft, nontender
CNS - NAD

Investigations :

Diagnosis : CKD ON MHD

Treatment :
1. INJ LASIX 40MG IV BD
2. TAB NODOSIS 500MG PO BD
3. TAB OROFER-XT PO OD
4. TAB SHELCAL PO OD
5. CAP BIO-D3 PO OD WEEKLY ONCE
6. INJ ERYTHROPOIETIN 4000IU SC WEEKLY ONCE
7. INJ IRON SUCROSE 1AMP IN 100ML NS IV OD WEEKLY ONCE
8. GRBS 6TH HRLY