A 45 year old female patient came with chief complaints of fever and vomitings since 10 days
A 45 year old female patient Homemaker by occupation came with chief complaints of fever and vomitings, decreased urinary output since 10 days
HOPI
Patient was apparently asymptomatic 1 yr back. Then she developed vomiting, pedal edema and decrease urine output since 1 week .They went to the hospital and was diagnosed with kidney disease and she had 2 dialysis sessions .
Now again after 1yr from 10 days she developed vomiting and fever and decreased urinary output.
Vomiting was non projectile and non blood tinged .Fever was associated with chills and rigor and increased during night time.
Patients daily routine
Patient is a homemaker and daily gets up in the morning and does house hold work.Before 4 yrs she worked as a agricultural labourer
past history
No history of DM,HTN, thyroid disorders, Tuberculosis,Asthma
Family history No significant family history
Personal history
Diet:mixed
Appetite: Decreased
Bowel and bladder : Regular
Addictions:No addictions
General examination
Patient was conscious coherent and cooperative
Moderately built and nourished
Pallor: present
Icterus: absent
Cyanosis: absent
Clubbing: absent
Generalized lymphadenopathy:absent
Edema : absent
Vitals
Temperature Afebrile
Pulse rate 75 bpm
Respiratory rate 14 cpm
BP 130/90
Systemic examination
Respiratory system BAE present normal vesicular breath sounds present
CVS s1 s2 heard no murmurs
GIT soft and non tender
CNS no focal neurological deficit
Investigations
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