Bilateral edema lower limbs

Female patient of age 75 comes in opd with complain of body pain weakness and bilateral lower leg edema Chief Complaints Mild fever Body pain Lower leg edema Weakness Backache Low urine output Vitals Bp140/90 Physical Examination Weak Investigations Cbc: lymphocytes:50 Kft: Blood urea:75 Serum creatinine:1.69 BUN:35.8 LFT: ALP: 104 Diagnosis Akd??? Uti?? Management I provide Tab amlo 5mg bd Cap:Omez dsr bd Syrup:Iron od Tab:dolo 500 mg Tab: cefexime 200 bd for 5 days Bp in control Fever not come but swelling Persist. What to do next

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KFTS are suggestive of derangement hence low urine output and hence oedema legs Lymphocytosis suggest chronic infectionand reason for fever body pain weakness This presentation needs xray chest ecg 2decho and usg abdomen No diabetic status given hence needs to workout D/d 1 AKD 2 DKD 3 secondary CRF to chf or corpulmonale 4 consequences of long standing hypertensionand age Rx provisonal for CRF Diuretics Antihypertensives Antibiotics like piperacillin+inj tazobactum

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Needs Sodium, Potassium, Hb%, and Urine RE, ME, C/S.USG of W/A. Rule out the AKD Or UTI. Replace the HTN drug for padel oedema.

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Dear Dr. Shoaib Aslam Sir, Advice for the case. Tab. Punarnava Guggulu 1 tds. Liq. Punarnavadi Kshay 30 ml BD. Tab. Chandra Prabha Vati 1 tds. Rasayan Churna 1/2 tsp tid.

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DD ? UTI ? DM, CKD Suggest Urine routine ,,C&S, RFT, ABG , Abdominal ultrasound Diuretics can be added.

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