NEPHROTIC SYNDROME
This is an online e-log platform to discuss case scenario of a patient with their guardians permission.
I have been given this case to solve in an attempt to understand the topic of patient clinical data analysis to develop my competency in reading and comprehending clinical data including histoty, clinical findings, .investigations and come up with a diagnosis and treatment plan.
A 22 year old female farmer by occupation resident of nalgonda came to hospital with a cheif complaint of bilateral lower limb swelling and facial puffiness decreased urinary output and SOB since 5 months
Now patient admitted for renal biopsy
History of present illness;
Patient was apparently asymptomatic 5 months back then she developed facial puffiness and peri orbital swelling preceded by bilateral limb swelling
Patient develops SOB while she walking for small distance,sometimes at resting position
Patient complaints of decreased urinary output
History of fever before the development of symptoms.
Patient took the treatment at nalgonda private hospital for same reason
Patient admitted in our hospital for same complaints in November.
Now symptoms are subsided and now patient admitted for renal biopsy
Past history;
No history of diabetes mellitus
No history of hypertension
No history of asthama and epilepsy
No history of surgery in past
Personal history;
Married
Apatite is reduced
Diet mixed
Micturation is abnormal
No known allergies
Habits .no addictions
MENSTRUAL HISTORY;
Age of menarche .15 years
Days of cycle.29 days
Family history;
No relavent history is found
General examination;
Patient is conscious,coherent,cooperative
INSPECTION:
Chest is symmetrical
Trachea – midline
PALPATION:
Chest movement: bilaterally equal chest movements
Trachea position is at midline
PERCUSSION:
Slight dull sound is heard on clavicular percussion
AUSCULTATION:
Normal Vesicular Breath sounds heard
ABDOMEN;
Shape of abdomen . scaphoid
No tenderness
Liver and spleen are not palpable
CNS;
Patient is conscious
Speech normal
PROVISIONAL DIAGNOSIS;
Nephrotic syndrome
INVESTIGATIONS;
Treatment;
Treatment:
Inj. Piptaz 4.5mg/ IV
Inj. Tramadol 1mg +100ml IV
Inj. Zofer 4mg IV
Tab. Ramipril 2.5mg BD
Tab. Lasix 20mg OD
Salt and Fluid restriction.
