69 year old male with itching and pedal oedema

​69 years old male with compliants of itching and pedal oedema

69 year old male , previously a farmer by occupation,came to hospital with chief complaints -

•itching all over the body 

•pedal oedema

•burning micturition 


History of present illness


Patient was apparently asymptomatic 15 days back , he suddenly developed itching all over his body while doing his work in fields, he observed oedema of his grafted leg a year ago and he is having severe itching at the grafted site .He is having burning micturition along with decreased urine output and nocturia.


History of past illness


No history of Diabetes, Hypertension,Asthma, TB

He had oedema of his right leg a year ago , he dad graft surgery which is healing now.


Personal history 


Diet:mixed

Appetite:decreased since 15 days

Sleep:inadequate 

Bowel: regular

Bladder:irregular

Urine output:reduced since 15 days

Addictions: no addictions


Family history 


Not significant 


Vitals

Blood pressure-120/60mm Hg

Pulse rate-82 bpm

Temperature- Afebrile


On examination 

Patient is consious,coherent and cooperative

Pallor, icterus, clubbing, cyanosis, koilonychia are absent

Pedal edema is present

Anemia is present



Small bumps on skin are observed due to chronic itching


SYSTEMIC EXAMINATION

CVS: S1 S2 heard, no murmurs/thrills
RS: NVBS heard, no dyspnoea
PA: Soft, non tender. 

CNS: NFND

INVESTIGATIONS 

On 25-02-2022 


Ultra sound report


On 27-02-2022












On 02-03-2022






Provisional diagnosis


AKI on CKD

Bilateral Hydrouretronephrosis



Treatment 

Inj.lasix 40mg IV/BD

Inj.PAN 40 mg IV/OD

Inj. Zofer 4 mg IV/OD








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