64/M with CKD
Case: 62 yr male with chief complaints -Loss of appetite from 1 month -SOB since 20 days -Cough since 15 days HOPI: -C/o shortness of breath since 20 days grade 4 ,no pnd and no orthopnea -Cough since 15 days ,non productive ,no haemoptysis Past history: K/C/O HTN from 5 years not on regular medication,DM from 5 yrs not on regular medication General Examination: Patient is conscious, coherent, co-operative Well oriented to time, place and person Moderately built and nourished No pallor, icterus, cyanosis , clubbing, pedal oedema, lymphadenopathy Vitals: PR:88bpm BP:160/90mm Hg RR:26 cpm Temp:98.7F Systemic Examination: CVS: S1S2 Present RS: BAE Present,NVBS P/A: Soft, non tender CNS:NAD Investigations: Provisional Diagnosis: CKD on MHD with diabetic nephropathy,K/C/O DM and HTN Treatment: 1)Salt and water restriction 2)INJ.CEFTRIAXONE 500 MG IV/BD 3)INJ.LASIX 40 MG IV/BD 4)INJ.ERYTHROPOIETIN 4000IU S/C WEEKLY ONCE 5)T.OROFER XT PO/OD 6)T.BIO D3 PO/OD 7) NEB.DUOLIN AND BUDECORT 6 th hrl...