GM case presentation 4

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A 54 yr male patient came to the casualty with the chief complaint of loss of appetite , nausea , decreased urine output since 20 days .

History of present illness: 

Patient was apparently well 20 months back, then he developed pedal edema 18 months ago , he went to nakrekal hospital and was given NSAIDS . Then on medication the swelling was subsided. And 8 months back he again developed pedal edema with loss of appetite and went to hyd hospital , then came to our hospital.

PAST HISTORY: 

Patient has hypertension . 

Not a known case of Tb , Epilepsy, Asthma , and Diabetes mellitus.

TREATMENT HISTORY: 

FAMILY HISTORY: 

No history of similar complaints in the past. No history of any cancer deaths in the family.

PERSONAL HISTORY: 

Pt takes mixed diet.                                            Normal  bowel movements.                                Irregular bladder movements.                          Appetite is decreased. 

GEMERAL EXAMINATION: 

Pallor is present.                                                  No icterus , no clubbing , no cyanosis, no  lymphadenopathy.                                                Pedal edema is present. 

Vitals : temperature :                                                          respiratory rate:.                                                    Pulse rate:                                                                blood pressure: 

SYSTEMIC EXAMINATION : 

CNS: s1 and s2 heard . No murmurs heard 

RESPIRATORY SYSTEM: