GENERAL MEDICINE ASSIGNMENT- MAY 2021

 A 80 year old male patient came with the complaints of fever and chills since 8 days  Decreased appetite, generalised weakness and burning micturition since 5 days HOPI: Pt was apparently asymptomatic 8 days back then he c/o fever a/w chills , intermittent without any diurnal variation No H/O vomitings or loose stools,cough,cold,SOB,rashes H/O scrotal swelling( hydrocoele) since childhood  H/O difficulty in passing micturition ?BPH  ?TURP done 1 year back(no records) H/O DM since 5 years on Tab.glimipiride 5mg and Tab.metformin 500mg H/O hypertension since 2 years on tab atenolol 50mg Personal history: Diet: mixed Appetite: decreased Sleep: decreased bowel movements: irregular addictions: tobacco smoking  burning micturition present S: General examination: Pt is C/C/C BP: 130/80 mmHg PR: 74 bpm Temp : 98.6F GRBS : 170mg/dl  Pt has icterus no pallor,  cyanosis, clubbing, lymphadenopathy, pedal oedema Physical examination: CVS:S1S2 +NO MURMURS  RS :BAE +, NVBS  P/A- soft, NT CNS-NFD Inv

60 year old male Pt came with the complaints of  abdominal distension since 15 days swelling of both lower limbs, upperlimbs  facial puffiness since 4 days   difficulty in breathing since 2-3 days HOPI : Patient was apparently alright 15 days back when he developed abdominal distension which developed gradually a/w b/l pedal edema, pitting type (R>L) , upper limbs edema and facial puffiness . Since 2-3 days he has SOB which is of grade II/ III  No h/o fever, decreased urine output, heamaturia and frothy urine No h/o chest pain/palpitations/giddiness/ neck pain  H/o CVA (right hemiparesis resolved now) 11 years back when he was also diagnosed with hypertension  H/o hypertension since 11 years on telmibind amh po/od H/o diabetes since 5 years on glimi m2 po/bd H/o right lower limb cellulitis 7 years back H/o ?right lower limb filariasis Personal history: Sleep-normal Appetite-normal Bowel and bladder movements-normal Addictions : Alcohol: occassionally Tobacco smoking: smoker 4 yrs ba