A 50 year old female with CRF



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 CLINICAL PROBLEMS WITH COLLECTIVE CURRENT BEST EVIDENCE BASED INPUT .

A 50 year old female patient presented with 
CHIEF COMPLAINTS :
Shortness of Breath in the morning and pedal edema and facial puffinness since 2days 

HISTORY OF PRESENTING ILLNESS:
Patient was apparently asymptomatic  since today morning then she had a shortness of breath ,then she was taken to govt hospital and given medication , sob reduced .
H/o pedal edema and facial puffinness 
No H/o decreased Urine output.

HISTORY OF PAST ILLNESS :- 
K/c/o HTN,2 years  on Nicardia 20 mg po/TID.
K/c/o CRF, 7 months 
not a k/c/o Diabetes mellitus, epilepsy

PERSONAL HISTORY:
No loss of appetite
Diet:mixed
Bowel movements: Regular
Addictions: Nil
FAMILY HISTORY:
No h/o similar complaints in the family
General Examination:
 Patient is Conscious , coherent, cooperative 

Pallor +
No Icterus/Cyanosis /Clubbing of fingers/toes /Lymphadenopathy
Oedema of feet+



VITALS:
Temperature:101 F
Pulse rate:125/min
Respiration rate:22/ min
BP:150/90 
Spo2: 98% on RA

SYSTEMIC EXAMINATION:
CVS: S1 S2 heard and no murmurs
Respiratory system:BAE +
PER ABDOMEN:SOFT NON TENDER
CNS:No neurological deficits


Dialysis done on
1st -31/3/22
2nd -2/4/22
3rd -05/04/22

INVESTIGATIONS:
27/03/22
ECG:


ABG:


LFT:



Hemogram:


RFT:

On 28/3/22
Serum iron 
on 29/3/22
RFT

On 30/3/22




On 31/3/22


On 3/4/22

SERUM ELECTROLYTES:



On 5/4/22


Provisional Diagnosis:
Chronic Renal failure with hypertension

TREATMENT GIVEN:
27/3/22 
1)FLUID RESTRICTION <1.5 LIT/DAY
2)SALT RESTRICTION <2GM/day
3)TAb.PAN40 MG PO/OD
4)TAB.NICARDIA 20MG PO/TID
5)TAB.NODOSIS 500MG PO/TID
6)TAB.OROFER XT PO/BD
7)TAB.LASIX 40MG  PO/BD
8)INJ.ERYTHROPOIETIN 4000 SC WEEKLY ONCE 

28/3/22
1)FLUID RESTRICTION <1.5 LIT/DAY
2)SALT RESTRICTION <2GM/day
3)TAb.PAN40 MG PO/OD
4)TAB.NICARDIA 20MG PO/TID
5)TAB.NODOSIS 500MG PO/TID
6)TAB.OROFER XT PO/BD
7)TAB.LASIX 40MG  PO/BD
8)INJ.ERYTHROPOIETIN 4000 SC WEEKLY ONCE 

29/3/22
1)FLUID RESTRICTION <1.5 LIT/DAY
2)SALT RESTRICTION <2GM/day
3)TAB.ERYTHROPOIETIN 4000 IV/SC
4)TAB.NICARDIA 20MG PO/TID
5)TAB.NODOSIS 500MG PO/TID
6)TAB.OROFER XT PO/BD
7)TAB.LASIX 40MG PO/BD

30/3/22
1)FLUID RESTRICTION <1.5 LIT/DAY
2)SALT RESTRICTION <2GM/day
3)TAB.ERYTHROPOIETIN 4000 IV/SC
4)TAB.NICARDIA 20MG PO/TID
5)TAB.NODOSIS 500MG PO/TID
6)TAB.OROFER XT PO/BD
7)TAB.LASIX 40MG PO/BD

31/3/22
1)FLUID RESTRICTION <1.5 LIT/DAY
2)SALT RESTRICTION <2GM/day
3)INJ.ERYTHROPOIETIN 4000 IV/ SC
4)TAB.NICARDIA 20MG PO/TID
5)TAB.NODOSIS 500MG PO/TID
6)TAB.OROFER XT PO/BD
7)TAB.LASIX 40MG PO/BD

1/4/22
1)FLUID RESTRICTION <1.5 LIT/DAY
2)SALT RESTRICTION <2GM/day
3)INJ.ERYTHROPOIETIN 4000 IV/SC
4)TAB.NICARDIA 20MG PO/TID
5)TAB.NODOSIS 500MG PO/TID
6)TAB.OROFER XT PO/BD
7)TAB.LASIX 40MG PO/BD

2/4/22
1)FLUID RESTRICTION <1.5 LIT/DAY
2)SALT RESTRICTION <2GM/day
3)INJ.ERYTHROPOIETIN 4000 IV/SC
4)TAB.NICARDIA 20MG PO/TID
5)TAB.NODOSIS 500MG PO/TID
6)TAB.OROFER XT PO/BD
7)TAB.LASIX 40MG PO/BD




3/4/22
1)FLUID RESTRICTION <1.5 LIT/DAY
2)SALT RESTRICTION <2GM/day
3)INJ.ERYTHROPOIETIN 4000 IV/SC
4)TAB.NICARDIA 20MG PO/TID
5)TAB.NODOSIS 500MG PO/TID
6)TAB.OROFER XT PO/BD
7)TAB.LASIX 40MG PO/BD



4/4/22
1)FLUID RESTRICTION <1.5 LIT/DAY
2)SALT RESTRICTION <2GM/day
3)INJ.ERYTHROPOIETIN 4000 IV/SC
4)TAB.NICARDIA 20MG PO/TID
5)TAB.NODOSIS 500MG PO/TID
6)TAB.OROFER XT PO/BD
7)TAB.LASIX 40MG PO/BD
8)TAB.ARKAMINE 0.1MG PO/BD


5/4/22
1)FLUID RESTRICTION <1.5 LIT/DAY
2)SALT RESTRICTION <2GM/day
3)INJ.ERYTHROPOIETIN 4000 IV/SC
4)TAB.NICARDIA 20MG PO/TID
5)TAB.NODOSIS 500MG PO/TID
6)TAB.OROFER XT PO/BD
7)TAB.LASIX 40MG PO/BD
8)TAB.ARKAMINE 0.1MG PO/BD

6/4/22
1)FLUID RESTRICTION <1.5 LIT/DAY
2)SALT RESTRICTION <2GM/day
3)INJ.ERYTHROPOIETIN 4000 IV/SC
4)TAB.NICARDIA 20MG PO/TID
5)TAB.NODOSIS 500MG PO/TID
6)TAB.OROFER XT PO/BD
7)TAB.LASIX 40MG PO/BD
8)TAB.ARKAMINE 0.1MG PO/BD



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