65 yr old male with decreased urine output

 

65 yr old male with decreased urine output

A 65 yr old male came with the complaint of 

Pedal edema  since 3 yrs

Shortness of breath on and off since 3 yrs

H/o burning micturition  and decreased urine output       since 3 yrs

No h/o NSAID abuse

HOPI:

Patient was asymtomatic 3 yrs back and then he developed pedal edema and SOB on and off since 3 yrs. and h/o burning micturition  and he was diagnosed with UTI , creatinine was -5 and on oral medication.

k/c/o HTN since 2 yrs and on TAB. PRAZOPRESS xL 5mg bd

k/c/o CRF since 3 yrs .?BPH

O/E :

Vitals

Bp:160/90mmhg

Pr:88bpm

Rr:18cpm

Spo2 : 98@RA

Temp:Afebrile

+pallor,icterus,cyanosis,lymphadenopathy,clubbing

Sys examination:

cvs:s1s2+

Rs: BAE+ ,nvbs

Cns: NAD

P/A : soft ,nontender

 

Investigations:

 

Provisional diagnosis:

CRF

Treatment:

1. Inj. Lasix 40mg iv bd

2. Tab nicardia 10mg po/od

3. Tab prazopress -xL 5mg po/bd

4. Tab mixomidine po /bd

5. Tab shelcal po od

6. Tab orofer xT po od

7. Tab nodosis 500mg bd

8. Inj iron sucrose 1 amp+ 100ml ns iv od weekly once