13YR OLD GIRL WITH NEPHROTIC SYNDROME
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A 13years old girl who is a student studying in hostel located at annaram,came with complaints of Bilateral lower limb swelling since 15days.
HOPI:Patient was apparantly normal 2months back and then she developed nausea and vomitings 4 episodes for 3 days.content food particles.Non bilious.Not associated with pain abdomen.No loose stools.Now since 15 days patient developed bilateral lower limb swelling initially till ankle and now progressed to generalised swelling with puffiness of face.
No history of SOB,No burning micturition,No fever,No skin rashes.
History of irregular menstrual cycles since menarche (achieved her menarche at 12 years)menstrual cycles were once in every 3 months.Last menstrual period 30/05/2022.
Not a known case odf DM,HTN,THYROID,CAD,CVA,BRONCHIAL ASTHMA.
History of acute gastroenteritis 2 months back.o
GENERAL EXAMINATION:
Bilateral pitting type of pedal edema present
NO PALLOR,ICTERUS,CYANOSIS,CLUBBING,KOILONYCHIA,LYMPHADENOPATHY.
VITALS:
Bp:110/80mmHg in left arm in sitting position
PR:78bpm
RR:16Cpm
BAE present.NVBS Present
CVS:S1S2 heard
CNS:NAD
Temperature:Afebrile
JVP:Not elevated
Input/Output:500/350ml
PROVISIONAL DIAGNOSIS:ANASARCA SECONDARY TO ?NEPHROTIC SYNDROME
TREATMENT:
1)Monitoring Bp,PR,Temperature.
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