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29 YEAR OLD FEMALE WITH SLE

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CASE DETAILS : 29 YEAR OLD FEMALE CAME TO OPD WITH COMPLAINTS OF POLYARTHRITIS , SWELLING WITH EARLY MORNING STIFFNESS IN JOINTS,  HAIR FALL, ORAL ULCERS SINCE 3 MONTHS HOPI : PATIENT WAS APPARENTLY ASYMPTOMATIC BEFORE 15 NOVEMBER 2021. ON 15 NOVEMBER 2021 PATIENT STARTED DEVELOPING FEVER , SWELLING AT SYNOVIUM OF ANKLE JOINT WHICH LATER LEAD TO  PEDAL EDEMA AND  ASSOCIATED WITH REDUCED PLATELET COUNT FOR WHICH SHE WAS TAKEN TO A NEARBY HOSPITAL WHERE  SHE RECEIVED THE TREATMENT AND LATER DURING THE HOSPITAL STAY SHE DEVELOPED PAIN IN ALL JOINTS ASSOCIATED WITH SWELLING AND EARLY MORNING STIFFNESS SINCE THEN. ALSO DEVELOPED PIGMENTATION OVER FACE , SCALP, BOTH EARS , NECK, BOTH HANDS AND LEGS, ARMS AND FOREARMS FOLLOWING WHICH SHE DEVELOPED ORAL ULCERS, THROAT PAIN WHICH IS ON AND OFF , THINNING OF HAIR AND HAIRFALL SINCE 1 MONTH  NO HISTORY OF PHOTOSENSITIVITY,  RAYNAUDS PHENOMENON  PAST HISTORY : H/O 1 EPISODE OF SEIZURES  3 YEARS BACK AFTER SUDDEN DEMISE OF PATIENT'S SISTER. 1 Y
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60 YEARS OLD FEMALE WITH SOB

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60 YEARS OLD FEMALE WITH SOB CASE DETAILS 60 year old female patient came with c/o SOB  since 3 days SOB ( grade III  progressed to grade IV ) over 3 days Aggravated while lying down (orthopnea ) HISTORY OF PRESENT ILLNESS  Pt. was apparently asymptomatic 3 days back then developed SOB  ( grade III  progressed to grade IV ) over 3 days Aggravated while lying down (orthopnea ) No c/o cough, fever, vomiting, loose stools No c/o pedal edema  PAST HISTORY    K/c/o HTN SINCE 10 YEARS and on medication ( metoprolol & Amlodipine tab. ) DM since 5 years and on medication ( metformin & glimiperide tab.) Not k/c/o CAD, TB, EPILEPSY PERSONAL HISTORY  DIET - MIXED APPETITE - NORMAL SLEEP - INADEQUATE BOWEL & BLADDER - REGULAR NO ADDICTIONS  GENERAL EXAMINATION  VITALS  Pt. Is c/ c/ c Temp - Afebrile  B.P. - 160/ 80 mm Hg P.R - 102 bpm R.R - 15 cpm GRBS - 340 mg /dl Spo2 - 95 % @ 5 lt o2 PHYSICAL EXAMINATION  PALLOR  - ICTERUS -  CYANOSIS - KOILONYCHIA -  LYMPHADENOPATHY - PEDAL EDEMA 
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46 year old female with PEDAL EDEMA AND CAME FOR DIALYSIS

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46 YEAR OLD FEMALE PATIENT WITH CKD ON MHD WITH HTN+ DM+ CASE DETAILS  46 YEAR OLD FEMALE PATIENT CAME TO HOSPITAL FOR DIALYSIS C/O PEDAL EDEMA (LT >RT) AND CELLULITIS IN LT LOWER LIMB  K/C/O CKD WITH DM SINCE 15 YEARS,  HTN SINCE 20 YEARS HISTORY OF PRESENT ILLNESS  PATIENT WAS APPARENTLY ASYMPTOMATIC   5 YEARS   AGO THEN SHE UNDERWENT EYE CATARACT SURGERY FOR RIGHT EYE  WHICH WAS NOT SUCCESSFUL AND THE PATIENT WAS ON CONTINUOUS PAIN KILLERS SINCE THEN FOR 4 MONTHS THEN SHE WENT FOR REGULAR MEDICAL CHECK UP 2 YEARS BACK AND FOUND OUT SERUM CREATININE TO BE 7.0. 10 MONTHS BACK DIAGNOSED AS KIDNEY INFECTIONS UNDERWENT MEDICAL TREATMENT AND DJ STENT HAS BEEN KEPT On 18 JAN 2022 PATIENT HAD SEVERE SOB (EVEN AT REST ) AND WAS ADMITTED TO LOCAL HOSPITAL FOLLOWING WHICH HER SERUM CREATININE WAS FOUND TO BE 14.0, SO A FEMORAL LINE WAS PLACED FOR DIALYSIS. SHE UNDERWENT 4 SESSIONS OF DIALYSIS FOLLOWING WHICH THE VEIN GOT CLOTTED AND LEAD TO PROGRESSIVE SWELLING OF THE LEFT LOWER LIMB AND DI
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55 YEAR OLD WITH PEDAL EDEMA AND SOB WITH DIABETES

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55 YEAR OLD MALE PATIENT WITH PEDAL EDEMA AND SOB WITH DIABETES  CASE DETAILS  A 55 YEAR OLD MALE PATIENT CAME TO THE CASUALITY   WITH  C/O PEDAL EDEMA SINCE 3 MONTHS NAUSEA AND VOMITING SINCE 10DAYS SOB SINCE 10 DAYS HISTORY OF PRESENT ILLNESS  PATIENT WAS APPARENTLY ASYMPTOMATIC 1 YEAR BACK THEN HE SUFFERED WITH FEVER ASSOCIATED WITH HEMATEMESIS FOR 10 DAYS AND RECOVERED AFTER USING MEDICATION AND WAS LATER DIAGNOSED AS DIABETIC AND STARTED MEDICATION. 3 MONTHS BACK HE DEVELOPED PEDAL EDEMA( GRADE III - IV ) WHICH WAS GRADUALLY PROGRESSIVE AND PITTING TYPE ALONG WITH FACIAL PUFFINESS PRESENT NAUSEA AND VOMITING SINCE 10 DAYS  SOB SINCE 10 DAYS  NO H/O REDUCED URINE OUTPUT, BURNING MICTURITION  PAST HISTORY    K/c/o DM SINCE 10 YEARS  NO H/O HTN, ASTHMA, EPILEPSY PERSONAL HISTORY  DIET - MIXED  APPETITE  - NORMAL  SLEEP  -  ADEQUATE  BOWEL AND BLADDER - REGULAR  NO ADDICTIONS GENERAL EXAMINATION Patient is conscious/ coherent /cooperative Moderately built and nourished Vitals : Temp -
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