General Medicine E-LOG

 General medicine

                                                                                                           -   108 Koushik

                                                                                      -   107 Sujeeth

                                                                                      -   3rd sem.

Under the guidance of Dr. Vamshi Sir (PG)

   This is an online e-log platform to discuss case scenario of a patient with their guardians 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, come up with a diagnosis and treatment plan.


Date of admission:-05/10/2021


Case scenario:-

A 46 year old male patient came with the complaints of shortness of breath since five days, profuse sweating, generalized weakness and pedal edema.


Chief complaints:- 

-Pedal edema, pitting type

-Facial puffiness since 10 days

-Upper limb edema

-Shortness of breath


History of present illness:-

Patient was apparently asymptomatic one month back then developed pedal edema which was gradually progressive associated with shortness of breath. 

No history of burning micturition.

No history of decreased urine output.

No history of Orthopnea PND.

No history of Fever



History of past illness:-

Known case of Diabetes Mellitus since 11 years(on regular medication Tab.Voglibose Tab.Gliclazide)

Known case of Hypertension since 3 years.


Personal history:-

Diet-mixed

Appetite-decreased

Bowels-regular

Micturition-normal

Has no known allergies

Alcohol-occasionally 

Non smoker


Family history:-

No h/o same complaints in family. No abnormality detected.



General examination:-

Patient c/c/c well oriented to time, place, person.

Moderately built, moderate nourishment.


VITALS

Pulse rate-96 beats/min

Respiratory rate-24/min

BP-140/90 mm/Hg

Temperature-Afebrile


Physical examination-

Pallor-present

Icterus-absent

Cyanosis-absent

Clubbing of fingers/toes-absent

Generalized Lymphadenopathy-absent

Edema of feet-present, pitting type


Systemic examination:-

CARDIOVASCULAR SYSTEM-

S1 S2 Heard

No thrills

No cardiac murmurs


RESPIRATORY SYSTEM-

Vesicular breath sounds heard

Trachea centrally in position

No wheezing

Tachypnea present




ABDOMEN-

Scaphoid shaped abdomen

No tenderness

No palpable mass

No hernial orifices

No free fluid

Liver and spleen are not palpable

No bowel sounds heard


CNS-

Conscious and normal speech

Normal gait

Cranial nerves normal

Sensory system normal

Motor system normal


INVESTIGATIONS-

On 5/10/21





























On 7/10/21





















Clinical images


























PROVISIONAL DIAGNOSIS


 Diabetic Nephropathy


Treatment

Support through Dialysis

On 7/10/21

Tab.Lasix 40 mg PO/BD

Tab.Gliclazid 50 mg PO/OD

Tab.Voglibose 0.2 mg PO/OD

Tab.Met XL 25 mg PO/OD

Tab.Almong 5 mg PO/OD

Tab.Oroter XT PO/BD

Tab.Pan 40 mg PO/OD

Tab.Nodosis 500 mg PO/BD


On 8/10/21


Tab.Lasix 40 mg PO/BD

Tab.Gliclazid 50 mg PO/OD

Tab.Voglibose 0.2 mg PO/OD

Tab.Met XL 25 mg PO/OD

Tab.Almong 5 mg PO/OD

Tab.Pan 40 mg PO/OD

Tab.Nodosis 500 mg PO/BD.





















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