Case presentation of copd patient

55 Y / M pt presented to casuality with c/o Blurring of vision since 1 year Decreased urine output since 2 months Pedal edema since 1 month SOB since 3 days Distended abdomen since 2 days Pt was apparently asymptomatic 10 yrs back , then he was diagnosed with DM type 2 , on has been using Glimi 2 mg tablets Pedal edema was gradually progressive There are no aggregating and relieving factors Pt is a k/c/o DM since 10 yrs , on Tab Glimi 2 mg HTN since 2 yrs , on T. Telma 40 mg Surgical history : Pt had below knee amputation 1 yr back , due to trauma to the left lower limb which developed cellulitis Pt is an occasional alcoholic since 30 years Chronic smoker since 20 years ( daily 1 pack of cigarette and 1 pack of beedi ) Medical h/o : Pt is on T Atorvastatin 10 mg T Pentoxifyllin 400 mg since 1 yr Not a k/c/o tb , asthma Occupation : Mason Appetite : normal Diet : mixed B& B : decreased micturition Pallor present CVS: S1S2+ No murmurs RS: DYSPNEA + Wheeze + inspiratory crepts in b/l ISA , IAA , IMA Trachea position-central. Vesicular breath sounds heard P/A: Soft, non tender DISTENDED Bowel sounds heard . CNS: NAD Provisional diagnosis : ? AKI with right heart failure ? COPD , with left below knee amputation K/c/o Type 2 DM since 10 yrs HTN since 2 yrs Investigations On 8/12/21 S urea 169 S creat 9.8

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