A 80 YEAR OLD MALE WITH AKI WITH DIABETIC NEPHROPATHY

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An 80-year-old male resident of Kamanpet was admitted with complaints of 

1) Acute urinary retention for past 24 hrs.

2) Fecal retention for the past 24 hours.

HISTORY OF PRESENTING ILLNESS

The patient was apparently asymptomatic a month ago then he began experiencing bilateral lower limb and knee pain. 

Patient experienced inability to defecate (accompanied by the absence of flatus) and urinate, along with shortness of breath since yesterday . 

No H/o of fever, nausea, vomiting.

C/o constipation two days ago. 

PAST HISTORY

K/C/o Hypertension since 10 Years 

Diabetes mellitus since 6 years.

N/K/C/o Asthma, Epilepsy, CAD, CVD, Thyroid disorders

GENERAL EXAMINATION

No pallor, icterus, cyanosis, clubbing, lymphadenopathy, edema

BP-110/70mmhg

PR - 70bpm

RR - 15 cpm

Spo2-98% at RA

SYSTEMIC EXAMINATION

CVS- S1, S2 heard, No murmur

R/S- BAE +, NVBS

P/A- Soft, Non tender

CNS- NFND

P/R : No anal tags, Anal fissure noted in 6’o clock posistion and No fistula

Anal tone decreased

Glove stained with stool 

                                               X RAY - ABDOMEN AND PELVIS

                                                        CHEST X RAY

ECG

                                                    2D ECHO

                                                  

                                                CUE ON 19TH AUGUST 

                                    

                                                        CUE ON 24TH AUGUST

                           

                                                 SERUM ELECTROLYTES

        

                                                               FBS 

HEMOGRAM ON 20TH AUGUST

HEMOGRAM ON 21 AUGUST

HEMOGRAM ON 24TH AUGUST

                                                     HbA1C

                                                      LFT

                                               URINARY ELECTROLYTES

                                                           PLBS

RFT ON 18TH AUGUST

RFT ON 20TH AUGUST

RFT ON 23TH AUGUST

RFT ON 24TH AUGUST

PROVISIONAL DIAGNOSIS

AKI WITH ?DIABETIC NEPHROPATHY

TYPE 2DM and HTN