37 year old male came to the casualty with the chief complaints of shortness of breath since 6 days and generalised swelling of the body since 15 days.

September 22, 2022

N. Lavanya

Roll : 93

5 th semester student.

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37 year old male came to the casualty with the chief complaints of shortness of breath since 6 days and generalised swelling of the body since 15 days.

History of present illness

The patient was apparently asymptomatic 12 years back then he developed generalized swelling all over the body which was insidious in onset and gradually progressed up to 3 months and then he came to our hospital and he was referred to the higher Centre afterwards.

In the higher Centre ,he was treated for about a 4 to 5 days and then he became normal and got discharged .

Before For 3 months he didn't take any alcohol or any smoking but after 3 months he again started drinking alcohol and smoking daily.
Afterwards he had on and off episodes of edema,so he was took a tablet of lasilactone and the edema subsided after taking the tablet. 2 months back he developed generalized edema which did not subside on medication, so he came to our hospital and was given lasix. 5 to 6 days back,he again started developing edema which didn't subside even after taking a higher dose of the tablet and he developed a shortness of breath from the past 4 days. He is not taking enough meals because he is having that SOB and distension of abdomen while sitting and eating. He had a good appetite but he was unable to eat. On September 14th around morning from 1:00 a.m. he had shortness of breath and around 3:00 a.m. he was not able to take breath and came to our hospital H/o dark colored stool since 4 day
H/o decreased urine output since 3 days
H/o dry cough ( sometimes only )
No h/o of fever and vomitings
He is a chronic alcoholic since 12 years
He takes alcohol almost daily about 90 ml
Last consumption of alcohol was 20 days back.
A chronic smoker takes 1 - 2 packs per day since 12 yrs

past History
No H/o of diabetes, hypertension, asthma, epilepsy, tuberculosis.

Personal history
Diet -mixed
Appetite-normal
Sleep - disturbed(unable to sleep in the night and slept in the mornings)
Bowel- dark coloured stools since 4 days
Bladder- decreased frequency and quantity
Addiction-
Chronic alcoholic since 16 years and nearly for 8 years he consumed daily around 90 ml

General examination
Pallor: absent
Icterus: yellowish discoloration of sclera-present
Cyanosis-absent
Clubbing-present
Lymphadenopathy:absent
Edema- generalised edema is