55yr old male with CKD

55YR OLD MALE WITH CKD

This is an online E log book to discuss our patients deidentified health data sharing after taking his or her /guardian signed inform consent.Here we discuss our individual patients problems through series of inputs from global online communities of experts with an aim to solve those patient's clinical problems with collective current best evidence 

CHEIF COMPLAINT

55yr old male farmer by occupation came to causality with  a chief complaint of generalised body pain,low back ache since past 2 yrs 
Pain radiating to low limbs from lower back

HISTORY OF PRESENT ILLNESS

He was asymptomatic, since few days he had pain in phalanges of both hands
Decreased urine output.No fever or cough
No weakness of limbs or sensory loss

HISTORY OF PAST ILLNESS
No history of diabetis,hypertension tuberculosis or asthma ,thyroid 

PERSONAL HISTORY 
Apatite-decreased
Sleep-decreased
Bowel movement-regular
No allergies 
Addictions-snuff,pan

GENERAL EXAMINATION 

patient is conscious, cooperative,  coherent 
No pallor
No cyanosis 
No lymphadenopathy 
No clubbing 
No icterus 
No oedema 

VITALS

Temperature:96.4
Pulse rate:84/min
Respiratory rate:18/min
Blood pressure:120/80mmhg
Spo2:99%

SYSTEMIC EXAMINATION 
CVS
No thrills
No cardiac murmurs
S1 and s2 sounds are heard
INVESTIGATIONS 

Treatment 

Tab lasix 40mg OD
Tab ultracet BD
Tab nodosis 500mg T/D

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