case of UTI

Case of UTI..
65 yr old female came with C/o 
---burning micturition since 4-5 days
---Decreased urine output since today morning 
---Pedal edema since 5-6 hrs 

HOPI : 
Patient was apparently asymptomatic 4 to 5 days ago then she developed
BURNING MICTURITION 
No h/o    loin pain , pain abdomen, fever & chills , vomitings, diarrhoea, itching in genital region, white discharge . 

C/o  DECREASED URINE OUTPUT  since one day, only few drops of urine was passed  &  went to the outside Hospital where the treatment of INJ. LASIX 40 mg was given after which she passed the urine 
No h/o fever, vomitings,diarrhoea 
No h/o hematuria , loin pain 

 C/o bilateral PEDAL EDEMA , insidious in onset, gradually progressive, pitting type , grade 2 ( upto knees). 
No h/o of exertional dysnea, orthopnea , PND, 
NO h/o of jaundice , pruritus , facial puffiness 

HISTORY OF PAST ILLNESS: 

k/c/o HTN since 6yrs & using T.TELMA mg OD 
N/k/c/o of Dm, BA, TB, EPILEPSY, CVA , THYROID DISORDERS . 

PAST SURGICAL  HISTORY : Hysterectomy 4yrs ago. 

 PERSONAL HISTORY : 
Diet : mixed
Appetite : normal
Sleep : adequate 
Bowel & bladder habits : regular, Burning micturition + 
No known addictions 

EXAMINATION : Pt is c/c/c
VITALS : 
TEMP : 98.6 f
HR : 75bpm
BP : 140/80 mm hg
RR : 18cpm
SPO2 : 98 % @RA
GRBS: 111mg/dl 

P/A : soft, obese ,suprapubic tenderness+ 
CVS : s1, s2 + . No murmurs 
RS : bae + NVBS + 
CNS  : NAD 

INVESTIGATIONS : 
CBP :
 Hb: 11.5
TLC:10,400
PLT: 5.57
N/L/M/E: 55/37/5/3

LFT : 
TB-0.98
DB-0.18
AST -25
ALT- 20
ALP-175
TP-6.8
A/G - 3.9

RFT :
SR.Cr - 1.1
Na+/k+/cl-  : 131/3.6/98
 
DIAGNOSIS :  ? Cystitis with AKI 
TREATMENT : 

1) IVF NS & RL @urine output + 30ml / hr
2) INJ. PANTOP 40mg i.v BD 
3) Inj. LASIX 20mg i.v BD

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