Dr.Keerthi Madireddy

 C/O DECREASED URINE OUTPUT AND SOB SINCE 4 DAYS  C/O PEDAL EDEMA SINCE 1 DAY  HOPI:  PATIENT WAS APPARENTLY ALRIGHT 4 DAYS BACK THEN HE HAD DECREASED URINE OUTPUT NO HESITANCY, NO DRIBBLING OF URINE C/O SOB GRADE III, ORTHOPNEA +, NO PND C/O PEDAL EDEMA SINCE 1 DAY WHICVH WAS PITTING TYPE COUGH SINCE TODAY ASSOCIATED WITH SPUTU, MUCOID, NON FOUL SMELLING, GENERALISED BODY PAINS+ LOSS OF APPETITE+ 3 EPISODES OF VOMITING+ 3 DAYS BACK, FOOD AS CONTENT  PAST HISTORY NO HISTORY OF DM, HTN,ASTHMA,EPILEPSY,CAD,CVA  PERSONAL HISTORY: DIET:MIXED SLEEP:ADEQUATE BOWEL: PASSED 4 DAYS BACK BLADDER: URINE OUTPUT DECREASED  ADDICTIONS:ALCOHOL DAILY SINCE 50 YEARS, BEEDI 10 SINCE 50 YEARS APPETITE:NORMAL  GENERAL EXAMINATION: PATIENT IS CONSCIOUS,COHERENT,COOPERATIVE,WELL ORIENTED TO TIME,PLACE AND PERSON.  NO PALLOR,ICTERUS CYANOSIS,CLUBING,LYMPHADENOPATHY,EDEMA. VITALS: TEMPERATURE:101 F BP:100/60 MM HG PR:90 BPM RR:18 CPM  SYSTEMIC EXAMINATION: CVS:S1,S2 HEARD NO MURMURS. RS:BAE +,NO MURMURS PER A

 PT C/O CHEST PAIN ON LEFT SIDE SINCE 2-3MONTHS WITH SOB SINCE 2-3 MONTHS WITH COUGH WITH EXPECTORATION  HOPI: PT WAS APPARENTLY ALRIGHT 2-3MONTHS AGO THEN HE DEVELOPED SOB(GRADE II)WITH COUGH WITH EXPECTORATION ,GREEN COLOURED WITH PALPITATIONS,COUGH INCREASES AFTER FOOD INTAKE AT NIGHT NIGHT TIME RISE OF TEMPERATURE PRESENT ASSOCIATED WITH SWAETING AND WEIGHT LOSS SINCE 3 MONTHS(15-20KGS) LOSS OF APPETITE,NAUSEA PRESENT NO C/O ABDOMINAL PAIN,VOMITINGS,DIARRHEA NO ORTHOPNEA,PND  PAST HISTORY: N/K/C/O DMII, HYPERTENSION,TB,EPILEPSY,CVA,CAD,ASTHAMA,THYROID DISORDERS.  GENERAL EXAMINATION: PATIENT IS CONSCIOUS,COHERENT,COOPERATIVE, WELL ORIENTED TO TIME,PLACE AND PERSON.  MODERATELY BUILT AND NOURISHED.  NO SIGNS OF PALLOR,ICTERUS, CYANOSIS, CLUBBING, LYMPHADENOPATHY, EDEMA  VITALS: TEMP: AFEBRILE BP: 120/80 MM HG RR: 76 BPM RR: 18 CPM  CVS: S1, S2 HEARD ,NO MURMURS RS: BAE +, NVBS CNS: NFND P/A: SOFT, NON TENDER, BOWEL SOUNDS HEARD  Investigation HEMOGRAM: HB: 9.6 GM/DL TOTAL COUNT: 116