R.Sravani General Medicine Case-1

  A 25 year old Male presented to OPD with chief  complaints of    vomitings 10 episodes and  bipedal edema and decreased urine output  since 3 years. HISTORY OF PRESENT ILLNESSES: Patient was apparently asymptomatic 3 years ago  then    he developed multiple episodes of vomitings  for which he was admitted in the hospital and found  to have high BP of 170 mm Hg HISTORY OF PAST ILLNESS: Known history of hypertension . Known history of Tuberculosis  No history of  Diabetes mellitus asthma, epilepsy. No history of surgeries, chemotherapy or  r adiotherapy  PERSONAL HISTORY:  Diet - Mixed    Appetite- Normal  Bowel movement is regular . Micturition - Normal  Addictions- None  Sleep    - Regular  FAMILY HISTORY : No history of DM, CAD, Asthma and thyroid  disorders in the family GENRAL EXAMINATION  Patient is conscious, coherent, co-operative. There are no signs of icterus, clubbing, pallor, cynosis, lymphadenopathy VITALS Temperature- 98.4   Pulse rate-    78 bpm Respiratory rate - 13cpm 

  A 60 year old male patient driver by occupation came to  casuality with the chief complaints of;  Pedal oedema since 15 days.   SOB since 1week.         Vomting since 1week.                                       Fever since 1week. Decreased urine output since 1week .     He is a known case of chronic renal failure and he is on hemodialysis and he underwent 7 sessions of hemodialysis.    HISTORY OF PRESENT ILLNESS; He was apparently asymptomatic 15 days back and he is completely normal and he can able to do his regular routine work. But 15 days back he developed oedema in his lower limb which is extended up to ankle which is pitting type. Fever which is continuous associated with cough and vomiting  since 1week.vomiting of one episode which is non projectile. Cough with sputum which  is red in colour and reduced after medication. SOB of grade 4 since 1week. PAST HISTORY; -He had a H/o dizziness  15 years back for which he went to hospital and diagnosed with diabetes and he discontinue