1601006100-swarnamukhi

​    A 30 year old female came to hospital with CHEF COMPLAINTS OF: Facial puffiness ,pedal edema since 3months. &Sob since 2days. HISTORY OF PRESENT ILLNESS: Patient was asymptomatic 3months back then she developed facial puffiness and bilateral leg swelling pitting type PAST HISTORY: Known clinical history of -chronic renal failure & hypertension. TREATMENT HISTORY: Using antihypertensive medications since 4yrs. FAMILY HISTORY: mother also have hypertension. PERSONAL HISTORY: -Married, house wife Appetite-normal ,sleep: inadequate Diet: veg Bowel and bladder: normal Known allergies:no GENERAL EXAMINATION: Patient is conscious, coherent, cooperative. -pallor on hands No icterus No clubbing, cyanosis Edema of both legs. VITALS: Temp-98.3c/f BP-110/80mm/hg PR-92bpm SP02-98% GRBS-104mg% CVS: -SIS2 HEARD RESPIRATORY SYSTEM: -BAE PROVISIONAL DIAGNOSIS: CHRONIC KIDNEY DISEASE Plan of care: hemodialysis INVESTIGATIONS: TREATMENT: Inj-epo 4000i.v s/c weekly Tab:Lasix 40mg po/BD Tab:ni

​ A 40/F Came with complaints of    1)Facial puffiness since 1 year  2)Itching all over the body since 1 year  and developed multiple plaques on abdomen and Lower limbs.                                                             3)abdominal distention since 1 month. 4)Sob on exertion since 1 month. 5)pedal edema since 5 days pitting type. H/O PRESENT ILLNESS 1)Patient was apparently asymptomatic 1 year back then she developed abdominal distension.           2)facial puffiness,itching all over the body                3)sob on exertion since one month.                              4)5 days ago she developed pedal edema (grade3) of both limbs.                                                         5)Decrease of urination since 10days    6)Patient complains of pain in both the knees and pain in abdomen. Pain -gradual in onset, progressive ,            Agressive on sitting & squatting            Relieved on rest. Itching scaly lesions all over the body. Abdominal distention: