51 year old with chronic kidney disease on MHD
51 year old male came with complains of ulcer on left foot and right foot since 3 months.
Ulcer was insidious in onset and gradually progressive( initally a blister progressed to present size) non healing type.
He was a k/c/o diabetes and hypertension since 30 years for which he was taking medication.
He had a history of difficulty in micturition 10 years back for which he went to hospital and diagnosed with CKD and was on medication.
4 months back he developed bilateral pedal edema and started dialysis ( maintenance hemodialysis). 20 dialysis were done in kims, narketpally and 10 dialysis were done in suryapet.
He has habbit of drinking since 35 years( 90ml- quarter/ day) .
Not a k/c/o asthma, tuberculosis, vascular and cardiac disorders.
No past history of similar complaints
No past history of hospitilization or surgery
FAMILY HISTORY:
No H/O Diabetes, Hypertension, Asthma, Epilepsy, Tuberculosis, CVA, CAD.
PERSONAL HISTORY:
Diet :mixed
Sleep :adequate
Bowel and bladder :regular
Appetite: normal
Micturition :normal
GENERAL EXAMINATION:
Patient is conscious coherent and cooperative
No pallor, icterus, cyanosis, clubbing, lymphadenopathy
Pedal edema present
VITALS:
Temperature:99 F
Pulse:82bpm
Blood pressure:150/90mm of hg
Respiratory rate:26 cpm
SpO2 :96%at room air
SYSTEMIC EXAMINATION:
CVS EXAMINATION:
s1,s2 heard
No murmurs
RESPIRATORY SYSTEM EXAMINATION :
Bilateral air entry present
Normal vesicular breath sounds heard
No added sounds heard
PER ABDOMEN EXAMINATION:
Scaphoid abdomen
No tenderness
No palpable mass
Bowel sounds heard.
Liver and spleen not palpable.
CNS EXAMINATION:
No abnormality detected.
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