46 year old , male resident of Devarkonda occupation : driver Came for regular dialysis During dialysis , he developed cough with hemoptysis ( 200ml ) saturations: 60spo2, got intubated. Past h/o : patient was apparently normal 8 months back, then he developed back pain , burning micturition, loss of appetite , decrease urine output. Back pain which was insidious on onset , gradually progressive no reliving and aggrevating factors for which he went to a near by RMP , pain subsided. After 2 months he developed sudden SOB, went to devarkonda hospital , For which they said he has kidney problem, had to go for dialysis. Later, he came to Kamineni Narketpalli Underwent dialysis , during dialysis he had COUGH, SOB, FEVER. Totally 10 dialysis done till last month. During the stay in hospital, he had one episode of seizures ( GTCS type) not a k/c/o seizures On tab: LEVIPIL. Later he was discharged , he was sent to Hyderabad...
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Q1 Reason for this ascites The most common cause of Ascites is Cirrhosis of liver risk factors in this patient : 1. Chronic alcoholism since 40 years 2. Truncal obesity leading to metabolic syndrome causing NAFLD leading to cirrhosis https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6092576/ Q2 Bilateral pedal oedema which is of pitting type is due to decrease in the albumin level trends due to course of the disease and long standing cirrhosis causing decrease in the production of proteins causing decrease in the oncotic pressure leading to accumulation of fluid. as per the given clinical data due to chronic liver disease there was increasing trend of INR which was as high as 4.7 causing bleeding manifestations ( bleeding gums, hematoma formation ) ulcerations are due his limited self practising manoeuvres done in inappropriat...