General medicine elog 2

 Hi, I am anirudh manne 3rd sem medical student. this is an online elog book to discuss our patients health data after taking his consent.This also reflects my patient centered online learning portfolio.

A 50 yr old patient housewife by occupation  resident of narketpally came to the hospital due to reduced urine output and shortness of breath 

History of present illness 

The patient was asymptomatic 6months ago later she was put on dialysis for the past 5 months 

1month ago she started to complain about decreased urinary output(oliguria) and shortness of breath(grade 3)

The patient complained about facial puffiness which was reducing in size as the days progressed so  was put under further dialysis

History of past illness

Patient is a known case of  hypertension since 7months

Not a known case of diabetes melitus ,asthma,tuberculosis

Family history

No significant family history

Personal history 

Diet:mixed

Appetite:normal

No allergies

No addictions in the past

Regular bowel movement

General examination 

No pallor

No icterus

No lymphadenopathy

No clubbing of fingers 

No poedal oedema

No cyanosis 

Moderately built 

Moderately nourished


Vital signs 

Bp:150/80

Pulse rate:86/min

Respiration rate:21cpm

Spo2:98%


Systemic examination 

Cardiovascular system

s1,s2 heart sounds heard

No additional sounds heard 

Respiratory system

Trachea central in position

Normal breathe sounds heard

Gastrointestinal system 

No tenderness over any region

No palpable mass in abdomen region

Central nervous sysytem

Patient is conscious 

Speech:normal

All reflexes are present

E.c.g





Lab reports
Serum iron





Haemogram 



Blood gouping


HIV rapid test



Random blood sugar 


Renal function tests


Dengue antigen test



Provisional diagnosis 

Chronic kidney disease on Maintenence haemodialysis 

Where is the anatomical position of the patients problem?

It is a disease where the patient suffers from decrease in the urinary output and facial puffiness 

The anatomical position of patient's problem is in the kidney located in the renal pelvis

Why is the patient having this problem?

Chronic kidney disease is usually caused by other conditions that put a strain on the kidneys. Often it's the result of a combination of different problems.

As the patient is known case of hypertension over time, this can put strain on the small blood vessels in the kidneys and stop the kidneys working properly.

Even the area where the patient belongs has high amount of chlorine content in the water which may also be the cause of the patients kidney failure.

What are we doing?(treatment)

The patient was given blood transfusion due to low platelet count and anemia

Haemodialysis on a regular basis(2times a week) through internal jugular vein is being done for the last one month.

Tests done:

Haemogram 

Serum iron

Dengue NS1 antigen

ecg

hiv rapid test

Renal function test

Random blood sugar

Drugs advised





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