A 22yr female came with c/o fever,anoraxia,headache,malaise etc. on examination i have seen severe pitting oedema on face,lower limb,and on abdomen spot dx and rx

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Swelling and puffiness all over body Abdomen is distended umbilicus is protruded or buldging Nails conjunctiva are pale and anaemic hemogram suggest vary low hematocrait values and low hb rest of reports are unremarkable Overall picture suggest pt has severe ascitis /general anasarca D/d 1 hypoproteinemia with anaemia Hepato renal disease Chf Chr respiratory disease Metabolic disorders And many more Case needs hospitalization and detail workout like usg abdomen and pelvis Xray chest ecg and other respective investigations Only i can stat do paracentasis and and send asitic fluid for analysis

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Abdominal Distended with umblicus protruded or bulging, Peyiotonial Ascites, Both lower limb oedema, Swelling & Puffiness all over body, low hematocrit values & hb blood pathological reports suggested anemia , raised SGOT, Do CXR P/A, USG W/A, ECG, Ddx, Anemia, Anasarca, Hypoproteina, GERD, Paratonial Ascites, R/O - CCF, Chronic Respiratory Disease, Hepatosplenomegaly, Hydronephrosis or CKD, Urgent Perform Paracentasis & send fluid from Analysis.

Thanx Dr. Pushker Bhomia Sir Ji
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Anasarca Iron deficiency anemia Normal renal functions Raised hepatic enzyme DD ? ANEMIA with severe hypoproteinemia , serum protein, AG RATIO need to be done ? ANEMIA with CCF, ECHO need to be done ? Cirrhosis of liver, abdominal ultrasound need to be done DM need to be ruled out

Thank you, Doctor
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IT'S A..CASE OF.. OEDEMA FEET, FACE. & EXTREMITIES AS WELL DISTENDED ABDOMEN. ? ANEMIA WITH HYPOPROTEINEMIA.. ? NEPHROTIC SYNDROME.. ? CCF .. NEED'S CLINICOPATHOLOGICAL EVALUATION WITH EXPERTS OPINION TO CONCLUDE DIAGNOSIS AND TREATMENT..

Ascites with resulting pedal edema There is no anasarca Microcytic hypochromic anemia Do Ascitic tap and investigate for Cytology, SAAG, Pro, Alb , Sugar, ADA and Malignant cells... Do USG whole abdomen...look for Lymph nodes, adnexal mass or Any e/o CLD

Investigate Blood total protein,Serum electrolytes and ECHO Seems to be a case of Anaemia and hyoprotinemia

Thank you doctor
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On examination it has come to notice that low haemoglobin and lowRBC level,puffy face , pitting oedema in the ,leg,and ascitisis of the abdomen.The patient is suferring from ascitisis with anaemia and other investigation like USG OF THD ABDOMEN,etc

CIRRHOSIS OF LIVER WITH ASCITES + EDEMA HYPOCHROMIC MICROCYTIC ANAEMIA BLOOD = SERUM PROTEIN ALB : GLOB H B s.Ag HCV AB P TIME & INR APTT Na + k+ UGI ENDOSCOPY FOR VARICES ASCITIC FLUID = PROTEIN CELLS ADA C& S ( EXCLUDE SPONTANEOUS ACTERIAL PERITONITIS = FOR CAUSE FOR FEBRILE SYMPTOMS) RX FLUID + SALT RESTRICTION ALDACTONE LASIX ASCITIC FLUID DRAINAGE + CONCOMITTENT IV HUMAN SERUM ALBUMIN TRANSFUSION DUPHALAC PO R CIFAX OO

This may be a case of Hypothyroidism with sever anemia with hypoproteinemic swelling Nephrotic may be there Ascetic may be due to hypoalbuminemia only Ush abdomen with pelvic HBSAG ANTI HCV T3 T4 TSH SERUM ALBUMIN Urine for albumin Lipids 2Decho

She has probably ascites. Dull percussion note at flanks will decide it clinically. She has clubbing of nails.it looks to be cirrhosis of liver.Usg & rest of lab findings. As Ascitic fluid tap & analysis of it will give clues of diagnosis. If exudate tuberculosis can be thought of

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