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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