GM Elog - 4

E-LOG GENERAL MEDICINE
Hi, This is Rithika, a fifth semester medical student. This is an e-LOG depicting patient's de-identified data centered approach for learning medicine. This log has been created after taking consent from  patient and his family. Here we discuss about patient's problems with a series of inputs with an aim to solve them

A 50 YR OLD FEMALE WITH ANURIA

Chief complaints :

Anuria since 3 days
Fever with chills since 3 days
SOB grade 3 since 3 days
Throat pain with difficulty in swallowing since 1 week

HOPI :

Apparently pt was asymptomatic 1 week ago
Then she developed few throat ulcers which made her difficult to swallow even water. 
She got treated for it in a local hospital but it did not get cured. 
Due to those ulcers, she couldn't even drink nor eat. 
Since 3 days, she developed fever with chills, anuria, SOB
Yesterday morning, they visited a govt hospital in suryapet, where they stayed till evening just to know that she was suffering with renal failure and hence the hospital cannot afford to keep them anymore. 
Then they had to immediately shift her to a private hospital in suryapet, who eventually rejected to admit her because of the same unethical reason. 
Later, yesterday night by 8pm they reached our hospital. 

Past history:

Nil significant

Personal history:

Sleep and appetite inadequate
Mixed diet
Bowel regular
Micturition - anuria since 3 days
No addictions and allergies

Family history : 

Nil significant

Systemic examination :

CVS :

S1 and S2 heard
No theills and murmurs

RS:

Dyspnoea present
No wheeze
Trachea central
Breath sounds vesicular
Rhonchi present

P/A :

Abdomen obese

CNS :

Conscious
Speech normal
No signs of meningeal irritation
Higher motor functions intact

Privisional diagnosis :

AKI

Investigations :

17/8/22









18/8/22










Treatment :

Emergency hemodialysis done yesterday night


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