A case study of pedal edema and other associated complaints

I've been given this case to solve in an attempt to understand the topic of "patient clinical data analysis" to develop my competency in reading and comprehending clinical data including history, clinical findings, investigations and come up with a diagnosis and treatment plan. 

You can find the entire real patient clinical problem in this link here..

https://alekyatummala.blogspot.com/2020/09/45-yr-female-with-anasarca.html?m=1

First I would like to discuss about the patient and the chief Complaints she Came with -

A 45year old female patient,who is a housewife come to the OPD which the chief Complaints of bilateral pedal edema and no Urine output Since 3 days.

Later on examination She was found to have abdominal distention and facial puffiness.

So now let us discuss what is pedal edema and what are the most common causes of pedal edema?

PEDAL EDEMA- Build up of fluid in the foot and ankle resulting in Swelling of foot is called as pedal edema.

Pedal edema can be unilateral or bilateral. 

Cause of bilateral pedal edema - Heart failure

                                                        - liver failure 

                                                        - Renal failure

                                                        - Lymphedema 

                                                        - Drugs like NSAIDS

She has HTN since 1 year and a diabetic since 5 years. She has on and off pedal edema since 6 months which aggravated on walking and relieved on taking rest for which she was advised to reduce the fluid intake at a local hospital.

On day 1,

Her blood pressure was 180/80mm Hg.

Abdomen distended.

Pitting type pedal edema.

On RFT Urea, Creatinine, Uricacid levels were found elevated - KIDNEY DISEASE

Reduced serum calcium, potassium, sodium.

CBC showed a microcytic, hypochromic anemia - IRON DEFICIENCY ANEMIA

Complete urine examination showed the presence of Albumin 

ABG showed a reduced PH and pCO2 with increased pO2 - METABOLIC ACIDOSIS

Blood sugar was found to be within normal limits.

But an ulcer was found on the right sole might probably suggest a poor glycemic control.

A provisional diagnosis of DIABETIC NEPHROPATHY with METABOLIC ACIDOSIS with IRON DEFICIENCY ANEMIA was made.

Treatment :

NaHCO3 inj

POTCHOLR syp 

OHA , Anti hypertensives