2.Chronic Liver Failure ( ESRD)
August 23rd
Date of admission - 22-01- 2021
A 22y- old - woman presented with blurry vision .
History of Present illness
The patient was apparently asymptomatic 8months back ,then she had blurry vision for a week and Hypertensive ( BP 220/70mm Hg) .Consulted to an Opthomologist , found a clot in the eye , suggested a complete body scan .
History of Past illnes -
No history of Weight loss.
Not a known case of HTN, CAD, Asthma, TB, Epilepsy, Thyroid disorders.
No history of surgeries and blood transfusions in the past.
Personal History
No history of consumption of alcohol.
History of low /minimum intake of water .
FAMILY HISTORY -
No history of DM, hypertension, CVA, CAD, Asthma, Renal disorders. Thyroid disorders in the family.
GENERAL EXAMINATION -
Patient is conscious, coherent, co-operative.
There is no icterus.
No pallor ,cyanosis, clubbing, koilonychia or lymphadenopathy.
VITALS -
Temperature- 98.6 F
Pulse rate- 98 bpm
Respiratory Rate- 20 cpm
BP- 230/70 mmHg
SPO2 at room air- 98%
SYSTEMIC EXAMINATION -
CARDIOVASCULAR SYSTEM:
Inspection:
Tactile vocal fremitus- Symmetrical
Chest wall is bilaterally symmetrical.
No precordial bulge
No visible pulsations, engorged veins, scars, sinuses
Palpation:
JVP: normal
Auscutation:
S1, S2 heard
No murmurs heard
RESPIRATORY SYSTEM-
Position of trachea: central
Bilateral air entry +
Normal vesicular breath sounds - heard
No added sounds.
PER ABDOMEN:
No tenderness
No palpable mass
No bruits
Bowel sounds heard.
CENTRAL NERVOUS SYSTEM:
Patient is Conscious
Speech: normal
No signs of Meningeal irritation
No neck stiffness
Motor & sensory system: normal
Reflexes: present
Cranial nerves: intact
Further Tests Done -
CBP , CUE ,HIV ,HbsAg, HCV , RFT,ECG , USG Abd , S.Iron ,BGT
Specimens collected - Blood , urine samples .
Reports
Final update
The patient is diagnosed with Chronic Renal Failure .
Treatment - Dialysis Twice a Week .
What are the other systemic complications in case of Chronic Renal failure other than blood clots .?
Why did the patient was asymptomatic with a BP over 220/70mm Hg ?
What are the Five stages of Chronic Renal failure?
What medications should be avoided during Dialysis?
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