Case of a 65 years old female with shortness of breath.

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This is the case of a 65 years old housewife, resident of Nalgonda.

CHIEF COMPLAINT

Patient presented with the chief complaints of 

Shortness of breath since 4 days 


HISTORY OF PRESENTING ILLNESS

The patient apparently asymptomatic 4 days ago , when in the morning she developed SOB after walking to the bathroom outside her house and coming back ( about 500m)(MMRC Grade 2 SOB) , it was insidious in onset , intermittent  , aggravated on walking and eating , and relieved on resting .


No history of orthopnea, PND, fever , cough , chest pain , sweating , palpitations


PAST HISTORY 

Not a known case of DM,HTN, Asthma, CVD , Thyroid disorders, Epilepsy

Known case of CKD since 4 years

Hospital admission for acute pancreatitis 4 years ago


FAMILY HISTORY

Not significant



PERSONAL HISTORY

Diet- mixed diet , 

Appetite- normal appetite , 

Regular bowel movements 

Normal bladder movements, no burning micturition , 

Addictions- 

occasional consumption of alcohol till 4 years ago

Consumption of chutta till 4 years ago

No allergies 


EXAMINATION

GENERAL EXAMINATION - 

Patient is conscious coherent and cooperative .

Well built and nourished 

Oriented to time, place and person.

Pallor , icterus , cyanosis , clubbing , Edema , lymphadenopathy -absent








SYSTEMIC EXAMINATION

 RESPIRATORY SYSTEM

INSPECTIONS 

Tachypnic breathing- present

Trachea central

Shape of the chest - elliptical 

Chest movements symmetrical

No drooping of the shoulders, 

No deformities of chest or spinal cord 

No scars and sinuses ,

No chest in drawing 


PALPATING 

No tracheal deviation 

Apical impulse felt 

Symmetrical chest movements 

No palpable lymph node 

Tactile fremitus- normal 


PERCUSSION 

Resonant tone heard in all areas


AUSCULTATION 

Normal vesicular breath sounds in all areas 


CVS

S1, S2 heard 

No murmurs 

No thrills 

Apex beat - normal 

No raised JVP



ABDOMEN

Shape of the abdomen- obese

No organomegaly

Soft , non tender


CNS

No focal neurological defects


PROVISIONAL DIAGNOSIS

?SOB secondary to CKD 

 

INVESTIGATIONS

22/6/23















23/6/23








2019












DISCUSSION VIDEO 











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