medicine Elog

 Hie,I am Sathwika  3 rd semester student.This is an online elog book to discuss our patient health data after taking his consent.this also reflect my patient centered online learning portfolio.   

Cheif complaints:: A 57 years old male patient who is agricultural labour by occupation came to opd with abdominal discomforts and  both legs swelling pedal edema from 5 days and he has decreased his urine out put from 2 dayz 

History of present illness :patient was apparently asymptomatic 5 dayz back then he developed pedal edema in both the lower limbs of pitting type 

History of past illness :c/o HTN :1 month 

No k/C/o :DM , CAD,Epilepsy , Tb

Treatment history :Diabetes: No

HYPERTENSION: YES

CAD : No

Asthma , TB ,antibiotics , surgery blood transfusion: No

Personal history :

Married

Occupation: agricultural labour 

Diet : Non veg

Bowels : regular

Micturition: Normal

Allergies : No 

Habits: 

ALCOHOL: occasionally 

Tobacco , drug use : No

Family history :

Diabetes: No

HTN : No

Heart disease: No 

Stroke : No

Cancers: No 

Tab : No 

Asthama : No 

Physical examination: 

Icterus , clubbing of fingers : NO

OEDEMA OF FEET : yes

Temp : 98.8F

Pulse : 90/ min

Grbs : 105 mg %

Systematic examination:

Thrills : No

Cardiac sounds : s1 S2 +

Cardiac murmurs : No 

Respiratory system:

Dysponea:No

Wheeze: no

Position of trachea:central

Breathe sounds : vesicular

ABDOMEN:

Shape of abdomen :scaphoid 

Tenderness: no

Palpable mass : no 

Liver , spleen palpable : no

BOWEL SOUNDS: YES 

CNS :consiousness 

Level of speech normal

All cranial nerves motar and sensory systems : normal

Reflexes : normal 

Cerebral signs : finger nose incordination: No 

Heel knee incordination : No

Provisional diagnosis : CKD on MHD , systemic inflammatory response syndrome .

Investigations ordered : 

Hemogram 

Lft , rft,CUE ,serum iron , chest x ray , ecg,, serology

Treatment: 

Tab : lasix 40 mg / bd 

Tab : Pan : 40 mg po/ od

Tab : nodosis : 500 mg / BD

Cap: bio d3/ po weekly once 

Tab : orofer-xt po/ od

Inj : erythropoietin 4000 u weekly once

Tab : nicaridia 5mg 

Q1 what is the anatomical location of the patient problem ?

Chronic kidney disease, also called chronic kidney failure, involves a gradual loss of kidney function. Your kidneys filter wastes and excess fluids from your blood, which are then removed in your urine. Advanced chronic kidney disease can cause dangerous levels of fluid, electrolytes and wastes to build up in your body.

In the early stages of chronic kidney disease, you might have few signs or symptoms. You might not realize that you have kidney disease until the condition is advanced.

Treatment for chronic kidney disease focuses on slowing the progression of kidney damage, usually by controlling the cause. But, even controlling the cause might not keep kidney damage from progressing. Chronic kidney disease can progress to end-stage kidney failure, which is fatal without artificial filtering (dialysis) or a kidney transplant

Q2. .why is the patient having the problem?

Chronic kidney disease occurs when a disease or condition impairs kidney function, causing kidney damage to worsen over several months or years.

Diseases and conditions that cause chronic kidney disease include:

• Type 1 or type 2 diabetes
• High blood pressure
• Glomerulonephritis (gloe-mer-u-low-nuh-FRY-tis), an inflammation of the kidney's filtering units (glomeruli)
• Interstitial nephritis (in-tur-STISH-ul nuh-FRY-tis), an inflammation of the kidney's tubules and surrounding structures
• Polycystic kidney disease or other inherited kidney diseases
• Prolonged obstruction of the urinary tract, from conditions such as enlarged prostate, kidney stones and some cancers
• Vesicoureteral (ves-ih-koe-yoo-REE-tur-ul) reflux, a condition that causes urine to back up into your kidneys
• Recurrent kidney infection, also called pyelonephritis (pie-uh-low-nuh-FRY-tis)

Risk factors

Factors that can increase your risk of chronic kidney disease include:

• Diabetes
• High blood pressure
• Heart (cardiovascular) disease
• Smoking
• Obesity
• Being Black, Native American or Asian American
• Family history of kidney disease
• Abnormal kidney structure
• Older age
• Frequent use of medications that can damage the kidneys
• Q3. What are we doing about it ?
• Pharmacological: by giving the Pt medication that can help pt in better condition 

• Tab : lasix 40 mg / bd 

  Tab : Pan : 40 mg po/ od

  Tab : nodosis : 500 mg / BD

  Cap: bio d3/ po weekly once 

  Tab : orofer-xt po/ od

  Inj : erythropoietin 4000 u weekly once

  Tab : nicaridia 5mg 

• And : by dialysis 
• Non pharmacological : Hemogram 

  Lft , rft,CUE ,serum iron , chest x ray , ecg,, serology

  Q complications and prevention?

  
  

  Complications

  Chronic kidney disease can affect almost every part of your body. Potential complications include:

  • Fluid retention, which could lead to swelling in your arms and legs, high blood pressure, or fluid in your lungs (pulmonary edema)
  • A sudden rise in potassium levels in your blood (hyperkalemia), which could impair your heart's function and can be life-threatening
  • Anemia
  • Heart disease
  • Weak bones and an increased risk of bone fractures
  • Decreased sex drive, erectile dysfunction or reduced fertility
  • Damage to your central nervous system, which can cause difficulty concentrating, personality changes or seizures
  • Decreased immune response, which makes you more vulnerable to infection
  • Pericarditis, an inflammation of the saclike membrane that envelops your heart (pericardium)
  • Pregnancy complications that carry risks for the mother and the developing fetus
  • Irreversible damage to your kidneys (end-stage kidney disease), eventually requiring either dialysis or a kidney transplant for survival

  Prevention

  To reduce your risk of developing kidney disease:

  • Follow instructions on over-the-counter medications. When using nonprescription pain relievers, such as aspirin, ibuprofen (Advil, Motrin IB, others) and acetaminophen (Tylenol, others), follow the instructions on the package. Taking too many pain relievers for a long time could lead to kidney damage.
  • Maintain a healthy weight. If you're at a healthy weight, maintain it by being physically active most days of the week. If you need to lose weight, talk with your doctor about strategies for healthy weight loss.
  • Don't smoke. Cigarette smoking can damage your kidneys and make existing kidney damage worse. If you're a smoker, talk to your doctor about strategies for quitting. Support groups, counseling and medications can all help you to stop.
  • Manage your medical conditions with your doctor's help. If you have diseases or conditions that increase your risk of kidney disease, work with your doctor to control them. Ask your doctor about tests to look for signs of kidney damage.