BIMONTHLY ASSESSMENT SEPTEMBER 2020
Q1 1)Anatomical diagnosis - pedal edema causes 1) increased hydrostatic pressure 2) decreased oncotic pressure 3) lymphatic obstruction ?kidney ?cardiac ?liver. Etiological diagnosis - ?long standing CKD ( 6months history of pedal edema) sr creatine and blood urea levels are high ?diabetic nephropathy ? nephrotic pattern hypoalbuminemia ? abdomen distension ? right heart failure 2)Reasons for i) azotemia - ?increased nitrogen in blood ? renal excretion is impaired ?CKD or renal AKI ii) anemia - ?CKD - decreased EPO iii)hypoalbunemia - diabetic nephropathy glomerural disease ? loss of albumin iv) acidosis - acidification of urine is lost H+ is accumulated in CKD 3)replacement of bicarbonates to counter metabolic acidosis as it is useful in normal anion gap metabolic acidosis IV BICARBONATE for fast replacement of bicarbonate deficit https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4227445/ 4)patient was showimg symptoms i)refractory anuria ii)metabolic acidosis 5)