Wednesday, 4 November 2020

52 yr male with ARF secondary to Rt pyelonephritis ?PCKD

This is an online E log book to discuss our patient's de-identified health data shared after taking his/her/guardian's signed informed consent. 


Here we discuss our individual patient's problems through series of inputs from available global online community of experts with an aim to solve those patient's clinical problems with collective current best evidence based inputs. 


This E log book also reflects my patient-centered online learning portfolio and your valuable inputs on the comment box is welcome. 


CASE PRESENTATION

52year old male came with cheif complaints of pain abdomen since 10days,pain in peri umbilical region and left iliac region since 10days,pedal edema (subsided),backache since 10days,no h/o vomitings,nausea,sob , palpitations,burning micturation

Alcoholic since 10years(local liquor)

Chutta (smoking)since 10days 2 to 3 times/day

C/o fever since 10days on and off intermittent associated with chills and rigors

Personal history

Decreased appetite

Sleep adequate

Bowel and bladder regular

Alcoholic since 10years(local liquor)

Chutta (smoking)since 10days 2 to 3 times/day

O/E

 Pt c/c/c

Pallor Present 

No cyanosis, clubbing,  pedal edema, lymphedenopathy

BP - 110/70 mmhg

PR - 88 bpm

CVS - S1S2

RS - BAE+

CNS No FND

P/A tenderness + in periumbilical region and left iliac region,mild hepatomegaly+

INVESTIGATIONS

BEFORE DIALYSIS


AFTER DIALYSIS


DIAGNOSIS - ARF SECONDARY  TO RT PYELONEPHRITIS 

                        ? PCKD


TREATMENT -

1. IVF 2 UNITS 0.45% NS , 1 UNIT RL

2. INJ PIPTAZ 2.25 GM/IV/QID

3. INJ LASIX 40mg IV/BD

4. INJ PAN 40 mg IV/OD

5. CIPROFLOXACIN 500 mg PO BD

6. TAB NODOSIS 550 mg PO BD

7. TAB SHELCAL 500 mg PO OD










No comments:

Post a Comment