This is an online E log book to discuss our patients deidentified health data shared after taking his/her/guardians signed informed consent.

Here we discuss our individual patients problems through series of inputs from available global online community of experts with an aim to solve those patients clinical problems with collective current best evidence based inputs.

This E log book also reflects my patient centered online learning portfolio and your valuable inputs on the comment box is welcome.

CASE PRESENTATION:


21 year old female from Darjeeling 

 2018 march at 19 years of age she got married and 

After 6 months : At 4 Months of amenorrhoea RTA ( abortion)


2019 june : NVD (baby girl) at 10 Months of amenorrhoea and all the trimesters were uneventfull.

 Her presenting complaints in 2020 November: Complaints of fascial puffiness( noticed by a neighbour) followed by abdominal distension after 2 days followed by pedal edema after 2 days associated with forthiness of urine since 3 months.

Frothiness of urine - fascial puffiness- abdominal distension( associated with pain abdomen predominantly in right iliac region) - pedal edema- SOB (7 days back) 

No h/o Orthopnoea PND fever burning micturition sore throat cough palpitations 

Vomiting Diarhhoea 

No raised JVP

H/0 hypothyroidism since 3 months on Tab Thyronorm (50 mcg OD)


No H/o chest pain , palpitations.

Not a k/c/o DM,HTN,TB,Asthma,epilepsy.

General examination:

Patient is conscious, coherent , cooperative.

Pallor+

B/L pedal edema + (upto pelvis)

No icterus,cyanosis,clubbing,lymphadenopathy

Vitals:

Temp - Afebrile

PR-114bpm

BP-120/80mmHg

RR-18cpm

Systemic examination:

CVS : S1S2 Heard

RS : BAE +

P/A : soft non tender

CNS : NAD

INVESTIGATIONS:
















DIAGNOSIS:

Nephrotic Syndrome.

TREATMENT:

Fluid and salt restriction 

TAB.TELMESARTAN 20mg po od

TAB.LASIX 40mg Bd

TAB.PREDNISOLONE 100mg od alternate day

TAB.MYCOPHENOLATE MOFETIL 500mg Bd

Strict I/O charting 

BP/PR/Temp Charting

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