A patient of 38 yrs with c/o loss of appetite, SOB,swelling of legs, Vomitings

A patient named P.Srinivas of 38 yrs residing at chautuppal working as labour came to opd with complaints of 
Chief complaints:
Swelling of legs -15 days
Decrease of appetite-15 days
Vomitings-15 days 
SOB-15 days
History of presenting illness:
Swelling of legs- insidious onset,numbness
Loss of appetite- insidious onset,
Vomitings- sudden onset
Sob- over working
History of past illness:
Htn-since 1 year tab.cilnidipine
Ckd-since 1 year ,on dialysis for 2 months
No history of ,DM,TB, Asthma, epilepsy, CAD

Family history:
Not significant 

Personal history:
Diet - mixed 

Appetite - normal

sleep - adequate overly sleepy 

Bowel and Bladder movements- Regular 

Addictions - stopped before a year

No known allergies

Drug history : 
Tab.clinidipine for htn
General examination:
Patient is conscious ,coherent ,cooperative and was well oriented to time ,place and person at the time of examination

He is examined in a well lit room, with consent taken.
He is moderately built and moderatly nourished.

Pallor - present 

Icterus - absent

Cyanosis - absent 

Clubbing - absent

lymphadenopathy - absent

Pedal edema - present 

Vitals : on the day of admission (12/4/2023)

Temperature - 98f

Pulse rate - 111 bpm

Respiratory rate -32  cpm

Blood pressure - 180/90 mmHg

SpO2 - 99% on Room air

GRBS - 134mg/dl

Systemic examination:-

Abdomen: 

    On inspection-
Shape of abdomen is elliptical and no scars. 

Normal movements and no visible pulsations.

    On palpation-

         On superficial palpation, abdomen is soft and non tender . No signs of ascites.

         On deep palpation,

Liver: large in size
Kidney: cyst at lower pole of right Kidney 
Sleep: normal 

     On percussion: tympanic note is heard

And no signs of ascites.

CVS:S1 and S2 heard, no murmurs 
Respiratory: airway normal
CNS: NAD

Investigations:
Hemogram:
Blood sugar:
Serum Iron:
LFT:
RFT:
DIAGNOSIS:
Fatty liver with rt. Renal cyst. 

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