Final pratical long case

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A 70 year old, labourer by occupation presented to OPD with chief complaints of 

Decreased urinary output since 30 days 

Burning micturition since 30 days 

Urgency and hesitancy of micturition since 30 days 

Mass per abdomen since 25days

History of present illness:-

Patient was apparently asymptomatic 30days back, then she noticed a decrease in urine output, burning micturition, urgency and hesitancy of micturition, so she visited to local hospital and investigations were done.

She denies h/o fever, loin pain, hematuria.

History of past illness:- 

She was hysterectomised 20 years back for fibroid uterus.

Not a know case of diabetis mellitus, hypertension, asthma, epilepsy, tuberculosis.

Personal history:- 

Diet- mixed 

Appetite- normal 

Sleep- adequate

Bowel movements- normal 

Family history:- 

No similar history in family members

General physical examination:-

Patient is conscious, coherent, cooperative 

Pallor present 

No icterus

No cyanosis

 Clubbing present

No generalized lymphadenopathy 

No pedal edema 

Vitals:- 

Temp- afebrile 

BP- 90 /50 mm hg 

PR - 86bpm

RR- 20 cpm 

Spo2- 98% 

Systemic examination:- 

Respiratory system:- bae+

CVS :- S1, S2 +

P/A:- distended, tenderness+ a hard mass of size 12×8 cm palpable in the suprapubic region 

CNS:- no abnormality detected




X RAY ERECT ABDOMEN
ECG

ULTRASOUND ABDOMEN


INVESTIGATIONS








Blood urea:- 25mg/dl
Serum creatinine:- 0.9mg/dl

DIAGNOSIS:- 

Urosepsis secondary to bilateral hydroureteronephrosis with bladder calculi with AKI with UTI.

Plan of treatment 

Tab.NITROFURANTOIN 100MG OD 

Tab.OROFER PO OD.

Tab.NODOSIS 500MG PO BD 

Tab.SHELCAL PO OD 

Tab.LASIX 20MG PO BD 



















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