Medicine e log

  A 61 year old male came to OPD with chief complaints of pain in abdomen since 10 days , distension of abdomen since 10 days , fever since 2 days.   History of presenting illness:  Pain is diffuse, progressive, dragging type  and is relieved by sleeping sideways.   abdominal distension associated with edema of legs(pitting type) fever since 2 days low grade continuous associated with chills and rigor.  General examination :   Presence of icterus   Presence of pedal edema  Abdominal Examination :  Inspection:  Abdomen is symmetrically distended with full flanks  Umbilicus is everted with slight horizontal slit   Abdominal girth is 84cms   Palpation: Superficial palpation: Localised tenderness in the right hypochondrium Deep palpation: liver is tender, smooth,firm,regular margins, moving with respiration , not able to insuate fingers under the coastal margin. Percussion :  Liver span:16 cms  No shifting dullness Investigations:  1. Complete blood picture 2.LFT Provisional diagnosis:  Mu

Long case presentation  Consent is taken from patient and family members   A 45 year old male resident of Nalgonda who is a labourer by occupation presented  with chief complaints of :  1)shortness of breath since 10 days   2)Cough since 9 days 3)Pedal edema since 9days  HISTORY OF PRESENTING ILLNESS: Patient was apparently asymptomatic 10 days ago,then developed   -Grade III  shortness of breath which was insidious in onset ,non progressive,aggravated by walking  and strenous work  and dressing , relieved by sitting              -There is history of orthopnea                         - There is no history of PND  -Dry Cough  since 9days which is insidious in onset , non progressive ,no aggrevating and relieving factors  -Grade III bilateral Pedal edema  since 9days which in insidious in onset , gradually progressive,pitting type , no aggravating and no relieving factors           -History of burning micturition and oliguria since 5 days  -There is no history of sweating , palpitations