A 39year old male patient with Renal AKI and polyarthritis






 A 39year old male patient came to the opd with the chief complaints of fever since 5days which was high grade,persistent with pedal Edema and associated with chills and 2 to 3 episodes of loose stools.

Facial puffiness was present since 5 days .

Generalised body swelling (anasarca)since 3 days and associated with SOB.

H/o burning micturition since 5 days and decreased urine output since 5 days.

No H/O chest pain,pain abdomen ,vomitings.

Past illness-

-H/O polyarthralgia since 1year associated with swelling of joints (large+small-ankle,wrist,fingers,knee,shoulders)along with restriction of movements and also painful movements which decreased 8 months back but again increased since 3 months.

-No History of DM/HTN/Asthama/epilepsy/CAD/TB


Treatment history -not significant 


Personal history-diet-mixed

                            -appetite -lost

-bowel and bladder movements -irregular 

Addictions-none 


Family history-Not significant


Vitals - 

PR - 96 

BP - 140/80 mmhg 

RR - 16 cpm 

GRBS - 131 mg/dl 

Temperature- 102.1F

Spo2 - 97% at room air 






General examination- 

Patient is conscious, coherent and cooperative 

No signs of pallor, icterus, cyanosis, clubbing and lymphadenopathy

Pedal Edema present 

Systemic examination-

CVS- S1,S2 +, no murmurs 

RS- BAE+

P/A- Soft, bowel sounds present

Tenderness + in the epigastrium and left hypochondrium 

CNS-NAD 

Investigations-


ECG

X-RAYS




Past investigations-




Diagnosis- 

Renal AKI (?ATN) secondary to sepsis on CKD(Secondary to analgesic nephropathy) with symmetric polyarthritis under evaluation with hypervolemic hyponatremia.

9/8/2021 investigations 


Serum urea,creatinine and serum electrolytes 



X-RAY LEFT FOOT BOTH PA AND LATERAL VIEW





2D ECHO DONE ON 9/8/2021







Comments

Popular Posts