A 38yrs/f suffering from joints pain(big) with puffy face and pedal oedema since 2 months. Pt is obese and hypertensive(on telmisartan+amlodipine) since last 10 yrs. Increased frequency of micturition with lower abd pain since 6 month. Non diabetic. Usg w/a reveals thickening of uterine endometrium and gr | fatty liver. Urine exam- WNL. Plz suggest treatment acordingly.



amlodipine induced pedal edema .plz switch over to other agents gradually. big joint pain may b due to gouty arthritis.-investigate accordingly. plz advice a C/S test for urine sample

Anti CCP is negative so ruled out RA. Low level of T3 is suggestive of hypothyroidism. Start with Levothyroxine 25mcg . Repeat thyroid function tests after 1 months Piroxicam or meloxicam or tramadol can be given as pain killer.

Thank u

Osteoarthritis, amlodipene induced oedema, UTI and obesity are the cause of his present complaint. Rx 1 Life style modification to control her wt. 2 gradual exercises for joints. 3 Stop CCB amlodipene. You can add diuretic or cilnidipin. 4 urine culture and AST. Antibiotic according to culture report. 5 NASID for pain relief.

Thank u sir

Plz do sr uric acid. That pedal edema due to ling term intake if AMLODIPINE . . Discontinued AMLODIPINE. . Treat accordingly sr uric acid .

Sr uric acid - 4.16

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Inferior wall ischaemia with sinus tachycardia, advised renal function tests.

First of all you Advice CBC,RFT, WITH S.URIC ACID.and repeat usg whole abdomen and electrolyte. Then start treatment.

Esr - 38, hb -13, sr uric acid- 4.16

Stop Amlo C & S urine Do Echo to ruled out pumping capacity Add Dieuretic Do S . protein & stop steriod if any

Ecg show Little st depression in lead 3, avf Non Nonspecific

Hypothyroidism + fatty liver +uti start with Thyronorm50 microgm then adjust dose. Antibiotics Vitamins and micronutrients. Inj vit D calcium

Thank u

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Pedal oedema due to Amlodipine discontinue it Go for CBC RFT Lipid profile Uric acid RA factor ANA till that start CTD 12.5 Ramipril 5mg

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