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VIRTUAL CASE BANK MEDICINE

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BIMONTHLY ASSESSMENT

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 50 yr old male working as carpenter resident of oligonda , married 30 yrs ago having 3 children ,elder daughter got married and other younger son and daughter are studying. His wife also works as daily labourer. Since past one year pt is not doing manual labour work and is just supervising contract based carpentry work and is at home most of the times ,as he is feeling weak . So their daily needs are met by her wife and younger son who started working since past year . Pt is a chronic smoker since 20 years - 10 vlbeedis /day Chronic alocholic since 20 yrs - wife doesn't know exactly the amount of alcohol. Since dialysis was started in 2019 around diwali time..pt stopped drinking and smoking. Not a k/c/o HTN,DM,TB,ASTHMA,CAD,CVA. No previous history of allergies/surgeries. H/o NSAID abuse present whenever pt did lot of manual work. In 2019 around diwali time pt noticed bilateral pedal edema extending upto knees and decreased urine output, but patient neglected the symptoms..went
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