40/F with facial puffiness since 1 year
A 40/F Came with complaints of Abdominal Distension since 1 year Facial puffiness since 1 year Itching all over the body since 1 year and developed multiple plaques on abdomen and Lower limbs Sob since 5 days pedal edema since 5 days pitting type H/O PRESENT ILLNESS Patient was apparently asymptomatic 1 year back then she developed abdominal distension, facial puffiness,itching all over the body and 5 days ago she developed pedal edema and SOB PAST HISTORY she developed knee pain 2 years ago and is under medication( demisone 0.5 mg and acelogic SR) Not a K/C/O DM/HTN/ asthma / Ischemic heart disease FAMILY HISTORY NO SIGNIFICANT FAMILY HISTORY PERSONAL HISTORY: OCCUPATION Daily wage worker DIET MIXED APPETITE decreased SLEEP NORMAL BOWEL AND BLADDER HABITS : decreased urine output ADDICTIONS: NO GENERAL EXAMINATION Patient is concious coherent and coperative VITALS BP 110/80 PR 90bpm TEMP 98.5degrees F SPO2 98 @ RA GRBS 106 NO PALLOR, ICTERUS , CYANOSIS, CLUBBING , LYM