56 male with c/o bilateral pedal edema
Patient with c/o bilateral pedal edema since 1 month , C/o fever and burning micturition since 20 days HOPI Pt was apparently asymptomatic 1 month ago back and then had complaints of b/l pedal edema pitting type followed by complaints of fewer low grade intermittent associated with burning micturition since 20 days No c/o loin pain ,hematuria, decreased urine output H/o NSAID abuse since 20 days K/c/o CKD 3 yrs H/o CVS 6 YRS AGO N/k/c/o DM ,TB, EPILEPSY ,HTN ,CAD General examination No pallor,icterus,cynosis,clubbing, lymphadenopathy. B/l ,pedal edema pitting type Vitals BP 110/60 mm hg PR 88 bpm RR 25 cpm Temp 100.6 °F Systemic examination RS-B/L air entry present NVBS CVS- S1s2present, no murmurs heard PA- soft and non tender. CNS - no focal neurological deficits Diagnosis CKD on MHD Septic shock Investigation 22/5/23 blood group O positive Anti ...