Harinarthini vaishnavi

  A 70 yr old female was brought by his son to the opd with the complaints of shortness of breath and bilateral pedal edema chief complaints: shortness of breath since one week bilateral pedal edema  since five days decreased urine output HISTORY OF PRESENTING ILLNESS: patient was apparently normal 5-6 years back.then she developed low grade fever on and off with generalised weakness and went to healthcare and diagnosed with diabetes. one month back she had loose stools in small quantity3-4 episodes per day for 1-2 days . since one week she deveolped shortness of breath initially on exertion but now at rest.bilateral pedema initially on ankle then generalised;facial puffiness and decreased urine output HISTORY OF PAST ILLNESS history of diabetes:5-6 yrs no history of hypertension,tb,epilepsy FAMILY HISTORY: Not a k/c/o asthma,tb.epilepsy.htn PERSONAL HISTORY: married occupation:daily wage labourer diet:mixed appetite:low bowel and bladder movements are abnormal no allergies used medica

  CASE SCENARIO  Pt aged 45 yrs F daily wage worker came to opd with chief c/o  bilateral pedal edema since 20 days and SOB on exertion since 20 days HISTORY OF PRESENT ILLNESS Pt has bilateral pedal edema ( pitting)  and SOB on exertion  HISTORY OF PAST ILLNESS N/k/c/o Dm and HTN TREATMENT  HISTORY  Pt is not on any medication PERSONAL HISTORY  Married Mixed diet Daily wage worker  PHYSICAL EXAMINATION  Patient is conscious, coherent and cooperative •Moderately built and Moderately nourished •No signs of - Pallor                        Cyanosis                        Clubbing                        Icterus Edema is present,pitting type VITALS • Temp -  •Pulse rate - 82 BPM •RP -  •BP - 130/70 mm hg •SPO2 -  SYSTEMIC EXAMINATION CARDIOVASCULAR SYSTEM • S1, S2 heard • No murmurs RESPIRATORY SYSTEM:   •Position of trachea - central •Breath sounds - vesicular ABDOMEN •Shape - scaphoid •  palpable liver •Spleen is not palpable  CENTRAL NERVOUS SYSTEM: • Intact • No focal defect • No abnorm

  51 year old male patient who is resident of chityal ,and works in a transportation company came to the hospital with complaints of  1- Fever since 10 days 2- Cough since 10 days  3-shortness of breath since 6 days  History of presenting illness :  Patient is apparently asymptomatic 10 days back then he developed. Fever since 10 days which is high grade , with chills and rigors , intermittent ,relieving with medication. Associated with cough and shortness of breath. Cough since 10 days which is productive ,mucoid in consistency,whitish ,scanty amount ,more during night times and on supine position ,non foulsmelling ,non bloodstained . Right sided chest pain - diffuse , intermittent ,dragging type , aggravated on cough ,non radiating ,not associated with sweating , palpitations. Shortness of breath since 6 days , insidious onset , gradually progresive ,of grade 3 - (MMRC scale ),not associated with wheeze ,no orthopnea ,no Paroxysmal nocturnal dyspnea, no pedal edema .  History of pain