62 yrs male with generalized body swelling and scrotal edema

A 62 year old male came to casuality with chief complaints of 

Generalized body swelling since 15 days 
Facial puffiness since 15 days 
Scrotal swelling since 15 days 


HISTORY OF PRESENTING ILLNESS

Patient was apparently asymptomatic 2years ( July 2021)  back, then developed weakness of right upper and lower limb associated with slurring of speech and deviation of mouth for which he was taken to hospital and diagnosed as right hemiparesis .

10 months back developed B/l  lower limb edema ( pitting type), upper limb edema and facial puffiness for which was managed conservately . 

15 days back again developed generalized body swelling, facial puffiness,sob and scrotal swelling .  



PAST HISTORY 

K/c/o hypertension since 1 yr and on T. Clinidipine 10 mg and furosemide 40mg .

K/c/o CVA with right hemiparesis 2 yrs back.  

Not a k/c/o DM .

PERSONAL HISTORY 

Diet - Mixed

Appetite- normal

Sleep- Adequate 

Bowel and bladder- regular 


Habits/Addiction: chronic alochol and smoker for 40 yrs 


FAMILY HISTORY 

not significant 

VITALS

Vitals @ Admission:

BP: 130/90 mmHg

HR: 88

RR: 16cpm

TEMP: 98.6

SpO2: 98%

GRBS:116mg%

General Examination:

Pallor - present 
Icterus - no 
Cyanosis- no
Clubbing -
Lymphadenopathy - no
Oedema of feet - present 


Systemic Examination:
CVS: S1S2 heard, No murmurs

RS: BAE+,NVBS

P/A: Soft, Non tender

CNS:  

Higher function test: 


Slurred speech  

Orientated to time place person.

Memory : Intact 





INVESTIGATIONS 
ON DAY OF ADMISSION (22/06/2022) 

HEMOGRAM:
Hemoglobin: 4.8 g/dl
TLC: 4000cells/cumm
Platelet: 1.20

ELECTROLYTES:
Na: 136
Cl: 108
K: 4.6


RENAL FUNCTION TESTS
Urea: 136
Creatinine: 10.6



ON 30/06/2022

HEMOGRAM:
Hemoglobin: 5.1 g/dl
TLC: 4300cells/cumm
Platelet: 1.35

RENAL FUNCTION TESTS
Urea: 158
Creatinine: 11.7
Phosphorus - 5.8




Provisional Diagnosis: 
CKD

Treatment:



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