BUTUKURI ANILA REDDY ROLLNO188

Chief complaints of Generalized body swelling since 3 days C/o pain Abdomen - 3 days Slurring of Speech - yesterday night Patient as apparently alright 3 days back then he had Generalised body swelling associated pitting edema Pain Abdomen Since 3 days. not diffuse not associated with nausea and vomitings. Slurring of Speech since yesterday Night. No weakness in ULand LL but pain in both LL. Tenderness present on touch 3. HISTORY OF PAST ILLNESS K/c/oDM-II since 3 years on insulin K/c/o CKD since 2 years K/c/o CAD 15 days back Pt had anasarca 15 days back weut to hospital& diagnosed with CAD and on conservative management Personal history  Appetite normal  Bowel and bladder movements regular  No Addictions  On examination    GENERAL EXAMINATION: Patient is conscious,coherent and cooperative, moderately built and malnourished Pallor: absent  Icterus: absent Cyanosis: absent Clubbing: absent Lymphadenopathy: absent Pedal edema: present VITALS: Temperature: 98 .2F Pulse: 116beats/minu

patient was apparently alright 3days back then she had shortness of breath which is grade 2 insidious in onset gradually progressive to  grade 4   Orthopnea is present  No H/o PND  Pedal edema present since 1month which was pitting type no  Fever since 3days ago low grade type which relived on medication  Past history  K/c/o CKD , HTN,DM-2 since 15years  K/c/o CAD 1month back advised for DTCA but not done  For diabetes she is using linagliptin 5mg OD HTN on amlodipine 5mg OD  Personal history  Appetite normal  Bowel    movements regular , Urine output decreased  No Addictions  On examination      GENERAL EXAMINATION: Patient is conscious,coherent and cooperative, moderately built and malnourished Pallor: mild pallor present  Icterus: absent Cyanosis: absent Clubbing: absent Lymphadenopathy: absent Pedal edema: present VITALS: Temperature: 98 .2F Pulse: 116beats/minute Blood pressure:130/70mm Hg Respiratory rate:20cpm SPO2 -83%at room air ,93%on 10L O2 GRBS 144mg/dl  Systemic examinatio