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Showing posts from September, 2020

CKD WITH HTN ON MHD

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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.   HISTORY OF PRESENTING ILLNESS:                                                                                                       A 65 yr old female from kodada whose was apparently asymptomatic 4 yrs back went to kodada government hospital with complaints of dizziness and diagnosed with hypertension(BP : 200/ ) and using medications from then 1 year later she developed anasarca and came to our hospital where she diagnosed with kidney failure (creatinine:3.0) and

Biweekly exam

Biweekly exam 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 arr

58year old man with decreased urinary stream since 3days and anuria and pain abdomen for 1day

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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 are welcome.  Here is a case i have seen:  A 58yr old male came with complaints of           Decreased urinary stream since 3days              not passing urine since 1 day           Pain abdomen since 1day. History of presenting illness:        Patient was apparently asymptomatic 4days back then developed cough which was not associated with sputum followed by fever which was low grade,continuous,not associated with chills then developed dribbling of urine and decreased urinary outp