Concluded Case

A old male have chest pain,shortness of breath. Prostate enlarged 28.83g.Liver enlarged, Sr Uric Acid 10.4 SGPT 336, loss of appetites, allergic asthma. Swelling foot, constipation. Please Rx and Dx.

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Concluded answer
Do PSA for Enlarged Prostate. Do IgG and IgM thyroid. Do MP and MF QBC method for leg Swelling and high Esonophilia. And complete liver profile. Only then we can decide
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Oedema legs, SOB, Proteienuria, hyperurecemia, hypocalcemia, prostatomegaly, all point to some renal involvement . Raised liver enzymes, low platelets . hepatomegaly, point to liver involvement . COPD,, rib erosion DD 1) Prostatomegaly, LUT obstruction, UTI, hyperurecemia -- early kidney disease 2) Alcohol or Hepatitis B related hepatitis , 3) COPD related SOB Suggest ECG, BS, F and PP, HbA1c, serum Protein CREATININE Ratio, Viral Hepatitis PROFILE, Vit D , and S Phosphorus
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Hepatomegaly raised sgpt B/l pedal edema suggest congestive changes >give diuretics Mediastinal widening is there/ upper lobe cavitatory lesion is there -go for HRCT thorax Give tamsulosin +dutasteridd Antiallergic Lactulosd Antibiotic acording to urine culture senstivity report Emperically loxof can be given If sputum--CBNAAT/AFB Ecg 2d echo
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Anaemia with prostetomegaly uric acid diathesis liver enlarge sgpt 336 cardiomegaly do fibroscan of liver 2 d echo lft serum protein tsh by that time start udiliv 300 mg bd silodal d hs febustat 40 mg bd zyloric 100 mg tds after reports we can add drug
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Cxray slight rotation Tracheal deviation towards right. Rt 1st , 2nd rib erosion and thinned out laterally. Sugg CECT thorax. Hyperuricemia and proteinuria. Sugg sr protein and 24 hrs urine protein, TFT, BP and BSL. 2d Echo. Ask history of steroids if patient is on.
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Neb with Dublin 6hrly and budecort 12 hrly...inj monocef 2g in bd...Tab azee 500mg bd....Tab febutas 40mg bd...Tab relent bd...And montairfx od....cxr s/o...copd with enteric fever...With hyperuricemia...Future plan 2d echo...And pft...
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I do agree with dr krishnan pichumani. But i would like to go for HRCT thorax,, ECG,, 2decho and thyroid functions too. Agreed with @Dr. Sandeep Ghodekar sir too
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Congratulations! Your case has been selected as Case of the day and you have been awarded 5 points for sharing the case. Keep posting your interesting cases, Happy Curofying!
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Do PSA for Enlarged Prostate. Do IgG and IgM thyroid. Do MP and MF QBC method for leg Swelling and high Esonophilia. And complete liver profile. Only then we can decide
Thank you doctor
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AGREE. WITH @. DR. KRISHNAN. PICHUMANI. JI AND @. DR. SANDEEP. GHODEKAR. JI.
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In simple language case khatam ...ghar le ja k seva karo ...
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