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doctor bhaskaaran

doctor bhaskaaran

wkfvcepdupscibtlbsbo, http://www.lmyhjkaety.com iaroburchp

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Provisional Diagnosis - Moderately severe anemia+renal failure Family h/o early CRF & Dialysis ?Inherited kidney disease
Final Diagnosis -
History and Findings - Tiredness,carpelspasm,leg cramps x 1 1/2yrs H/o Anemia (7g) during pregnancy 3yrs back Family h/o CRF (Father-died at the age of 40yrs after dialysis for CRF x 2yrs). O/e Wt-46k BP-130/80 DNS++Lt Thyyroid N,Pallor++ No Palpable kidneys No facial/Pedal edema
Investigation - Hb-7.9g,Low MCV low MCH,ESR-30,Plat-389.0,Retics-0.49%(low),Absolute retics-14(Low),urine 4-6PC/HPF,BU-115,S.Creatinine-5.5,uric acid-7mg,Ca-9mg,Phos-6.9,Na-132.7,K-4.6,HBA1c-5.8%,A/g-4.65/4g,ALP-67.6,LDH-173.5,Iron-97,Ferritin-53.65,ATg-65.38 normal <4.11,PO-1.36,Lipids normal,24 hr urine protein-247.8,ANA IFA-Neg,C3-86.45(N),C4-25.58(N),ds-DNA-15.1(Neg),Urine Na-51.4,Stool OB/Fat-Neg,ASO-neg,P.Smear-Notmocytic normochromic anemia,C-ANCA,P-ANCA-Neg USG abd-RK 9.9x4cm parenchyma 15mm LK-10.3x4.9cm,Parenchyma 19mm Increased B/l cortical echoes,poor corticomedullary differentiation,multiple simple cortical cyst 8-9mm B/l impression:Chr Renal Parenchymal disease with secondary cystic changes Inv pending-Eye examination for retinitis pigmentosa,Lentoconus & for vasculitis changes/Uremic retinopathy ENT-Puretone audiogram 24 hr urine Ca oxalate
Treatment - Advised-Nephro consultation & Renal biopsy
Follow Up -

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Provisional Diagnosis-Moderately severe anemia+renal failure Family h/o early CRF & Dialysis ?Inherited kidney disease
Final Diagnosis-
History and Findings-Tiredness,carpelspasm,leg cramps x 1 1/2yrs H/o Anemia (7g) during pregnancy 3yrs back Family h/o CRF (Father-died at the age of 40yrs after dialysis for CRF x 2yrs). O/e Wt-46k BP-130/80 DNS++Lt Thyyroid N,Pallor++ No Palpable kidneys No facial/Pedal edema
Investigation-Hb-7.9g,Low MCV low MCH,ESR-30,Plat-389.0,Retics-0.49%(low),Absolute retics-14(Low),urine 4-6PC/HPF,BU-115,S.Creatinine-5.5,uric acid-7mg,Ca-9mg,Phos-6.9,Na-132.7,K-4.6,HBA1c-5.8%,A/g-4.65/4g,ALP-67.6,LDH-173.5,Iron-97,Ferritin-53.65,ATg-65.38 normal <4.11,PO-1.36,Lipids normal,24 hr urine protein-247.8,ANA IFA-Neg,C3-86.45(N),C4-25.58(N),ds-DNA-15.1(Neg),Urine Na-51.4,Stool OB/Fat-Neg,ASO-neg,P.Smear-Notmocytic normochromic anemia,C-ANCA,P-ANCA-Neg USG abd-RK 9.9x4cm parenchyma 15mm LK-10.3x4.9cm,Parenchyma 19mm Increased B/l cortical echoes,poor corticomedullary differentiation,multiple simple cortical cyst 8-9mm B/l impression:Chr Renal Parenchymal disease with secondary cystic changes Inv pending-Eye examination for retinitis pigmentosa,Lentoconus & for vasculitis changes/Uremic retinopathy ENT-Puretone audiogram 24 hr urine Ca oxalate
Treatment-Advised-Nephro consultation & Renal biopsy
Follow Up-

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Provisional Diagnosis-Dyspepsia/Wt loss/upper ab pain/vague mass epigastrium ?GI Malignancy
Final Diagnosis-Adenocarcinoma pancreas with liver METS
History and Findings-SHTN x 1yr,dyspepsia x 2months,upper abd pain,retrosternal burning x1month,Wt loss 60kg-51kg in 2months. O/e vague mass epigastrium tender
Investigation-Hb-10.5,ESR-20,HBA1c-5.8%,S,Creatinine-1.4,Amylase-49.3,Lipase-40,CRP-1.45,CA 125-51.6,CeA-76.33,25(OH)Vit D-19.15,Stool fat +ve,OB neg,OGD scopy 18/11/11-Hiatus hernia,Colonoscopy same day normal study.MDCT abd contrast & CA 19-9 on 18/11/11 scan shows an ill defined irreular marginate mildly enhancing lesions in body & tail of pancreas with proximal dilatation of main pancreatic duct with multiple peripherally enhancing lesions noticed in both lobes of liver s/o METS (CA 19-9)5430.5
Treatment-Referred to RCC TVM on patients request for tissue diagnosis & management
Follow Up-

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