07 A.S.SIVARAM

  AKI 2° to Rt nephrectomy  Case scenario:- PT aged 40 yrs F Farmer by occupation came to opd with c/o of Vomitings since 15 days nausea since 15 days Pt was apparently normal 4yrs back then she had burning micturition pedal edema and rt loin pain and diagnosed with renal calculi(2 to 3 cm) Pt has right kidney nephrectomy in 2018 HISTORY OF PRESENT  ILLNESS Since 10 to 15 days pt had nausea and Vomiting  HISTORY OF PAST ILLNESS Right kidney nephrectomy in 2018 N/k/c/o BP and HTN PERSONAL HISTORY  Mixed diet Married Farmer by occupation  PHYSICAL EXAMINATION  Patient is conscious, coherent and cooperative •Moderately built and Moderately nourished •No signs of - Pallor                        Cyanosis                        Clubbing                        Icterus VITALS • Temp - 98.4F •Pulse rate - 82 BPM •RP - 16 /min •BP - 130/70 mm hg •SPO2 - 98 SYSTEMIC EXAMINATION CARDIOVASCULAR SYSTEM • S1, S2 heard • No murmurs RESPIRATORY SYSTEM:   •Position of trachea - central •Breath sounds -

 CASE SCENARIO:- A 6yr old child came to OPD with chief complaints of pain in the chest and abdomen since 3 months. HISTORY OF PRESENT ILLNESS:- Patient was apparently asymptomatic 4 months back after that she developed pain in the chest and abdomen. PAST HISTORY:- * There is no past history. TREATMENT HISTORY:-  *No treatment history. PERSONAL HISTORY:- *Diet is mixed. * Appetite is Abnormal. * Bowel movement is irregular. * Bladder movement is Normal. * No known allergies.  * No addiction to smoking and alcohol. FAMILY HISTORY :- * Her mother is suffered with TB. PHYSICAL EXAMINATION:- *patient is conscious, coherent and cooperative. *No signs of  pallor, icterus, cyanosis, clubbing, lymphadenopathy, pedal oedema 

CASE SCENARIO:- *A 28 yrs old female came to opd chief complaints of pain at right hypochondrium, pain in the left flank, shortness of breath, tiredness(since 2 years). HISTORY OF PRESENT ILLNESS:- *pain increases while sitting for long time. HISTORY OF PAST ILLNESS:- *TB in 2007 *Hematuria on 25th May 2022 TREATMENT HISTORY:- *Homeopathy for SOB. PERSONAL HISTORY:- *Diet is mixed. *Appetite is normal. *Bowel movement is regular. *Bladder movement is normal. *Micturition normal. *No known allergies. *No addiction to alcohol and smoking. FAMILY HISTORY:- *No H/O of HTN, DM. *Father having gastric problems. *Father having hernia. MENSTRUAL HISTORY:- *Periods are irregular since 2 months. PHYSICAL EXAMINATION:- *No pallor, icterus, cyanosis, clubbing. *No lymphadenopathy. *B.P- 110/70 mmHg *Temperature- 98.6 F *Pulse rate- 66per min. PROVISIONAL DIAGNOSIS:- *Right upper lobe fibrosis secondary to old pulmonary tuberculosis. INVESTIGATIONS:- #Hemogram:- Hb-12.1 TLC-8800 N/L/E/M/B-58/34/4/4