2nd Internal examination













  


 






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53yr male with swelling of face

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 A 53-year-old male, a Hotel owner and chief by occupation, The patient presented to the hospital with chief complaints of Swelling of both Legs since 10 days Swelling of face since 7 days HISTORY OF PRESENTING ILLNESS   The patient was apparently asymptomatic 10 days ago.In the first week of June he had a binge of alcohol on occasion of local festival. Later he observed abdominal distension, followed by Bilateral Pedal odema which is pitting type extending up to the knee, insidious in gradually progressive , since one week . Patient has decreased urine output since 5 days not associated with burning micturation  yellowish discolouration of urine  No c/o - Chest pain, Palpitations , Shortness of breath ,Orthopnea, PND No c/o - Fever , Vomitings , loose stools. PAST HISTORY Not K/N/C- Hypertension, Epilepsy, Thyroid disorders. PERSONAL HISTORY Mixed diet, decreased appetite,constipation  decreased urinary frequency. K/C/O - Chronic Alcoholic since 20 yrs , every ...
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