48 yr female with anasarca( internal assessment)
1) What is your complete anatomic and etiologic diagnosis from the data available in the patient's online record linked above? (ignore the provisional diagnosis on admission mentioned in the case report) Ans) glomerular damage( cytokinine mediated podocyte injury) Right heart failure Etiology: CkD due to diabetic nephropathy nd hypertension 2)What are the reasons for her: Azotemia : renal failure ( decrease excretion of nitrogenous waste) Anemia : iron deficiency amemia ( microcytic hypochromic anaemia) nd CKD As mcv less than 100) Decrease iron stores Hypoalbuminemia ( protinuria basement damanage nd podocyte damage) ndto some extent nutritional cause) Acidosis : decrease bicarbonate reabsorption( acidification of urine lost) What was the rationale for her treatment plan detailed day wise in the record? Day 1 injNaHO3: to control the acidosis Normally NaHCO3 given in N anion gap C/I in high and low anion gap Syp potchlor for hypokalemia Day 2: inj Hai acc to sliding sc