Days in medicine posting

50F presented to opd with complaining sob since 1day and pedal edema since 2days. Pt apparently asymptomatic 4yrs back then she developed pedal edema gradual onset intermittent type (on&off) aggrevated on rest, relieved on work, progressed to upper limbs and face subsided without medication. SOB since yesterday sudden onset and progressive in nature.a/w palpitations. No chest pain, headache. No h/o orthopnea,PND. PAST HISTORY:  K/c/o HTN since 2yrs & on metoprolol 50 mg No h/o dm, Asthma, seizures,ckd, TB  H/0 hemirrhoidectomy 4yrs back  H/0 arthritis since 2yrs for which intra articular injection given. PERSONAL HISTORY : farmer by occupation.appetite normal, bowel & bladder movements regular. GENERAL PHYSICAL EXAMINATION:  Moderately built and nourished. Pallor + ;no icterus ,cyanosis ,clubbing ,koilonychia, generalized lymphadenopathy.  Pedal edema B/L pitting type Resolved  by 17/09/20 Jvp raised  Vitals  Temperature afebrile bp 140/80 rt arm supine posit

A 20yr male presented to our opd with oocomplaints of - high grade fever since 1ooweek associated with vomiting 3episodes /day,bilious vomiting since 2days  on empty stomach,food contents as particles when he eats . -body pains since 3days aggrevated on sleeping relieved on walking -h/o malena since 2days -he was apparently asymptomatic 2months back,later he developed palpitations, shortness of breath, dizziness and headache for which he went to cardiologist at nalgonda and was told that he had irregular heart rate for which he was prescribed few medications and symptoms relieved.Now he developed fever since 7days which is high grade, intermittent type associated with vomiting of 2-3ep/dayand loose stools with foul smelling and mucus but no blood in stool. PAST HISTORY:  K/c/o BPPV  -He is not a k/c/o DM,HTN, seizures,asthma PERSONAL HISTORY:  he is a degree final yr student,his diet was mixed, decreased appetite, constipation since 3yrs normal micturition,non alcoholic and non smoker

 1)Anatomical diagnosis -? Glomerulosclerosis                                                                        Etiological diagnosis -  ?? Nephrotic syndrome secondary to the diabetic nephropathy or CKD.      2)Reasons for I) Azotemia : impaired renal excretion of urea and creatinine secondary to CKD.  II) Anemia : decreased erythropoietin.  III) Hypoalbunemia: capillary basement membrane and podocytes damage.  IV)  acidosis: acidification of urine is lost.                                       3) Rationale : syp potchlor was given because of the hypokalemia.. Inj. NaHCO3 was given because of metabolic acidosis ..Insulin and antihypertensives are given because known case of DM and HTN. Orofer XT was given because of anemia.. Inj. Lasix was given to decrease her volume overload. Spironolactone was given it was a potassium sparing diuretic.Calcium was given to the patient  because of hypocalcemia secondary to CKD. Indications of NaHCO3:metabolic acidosis in cardiac arrest, Tricycli

A 48 year old Male patient , a farmer by occupation presented to opd  with  C/o :  fever since one week  Pain abdomen since one week associate with loose stools . Yellowish discoloration of eyes since one week Pedal edema since 5 days  Decreased urine output since 5 days c hematuria 4 days back HOPI : Patient was apparently asymptomatic one week back then he presented with c/o  Fever since one week,  high grade fever , continuous , not associated with child and rigors .associated with pain  abdomen..all over the abdomen , more in rt hypochondrium  .. h/o  : loose stools 5 episodes within 24hrs ,. 4 days  back  And h/ o : yellowish discoloration  of sclera skin and mucous membranes since one week   c/o b/l pedal edema since 5 days , from ankle to knee .. pitting type ..associated with burning micturation ,, and decreased urine output since 5 days  And hematuria 4 days back after receiving treatment in a local hospital in suryapet. patient then went to osmania  general hospital and got