60 year old women with chief complaints of loss of appetite, disturbed sleep and pain in lower limbs

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CHIEF COMPLAINTS:

Loss of appetite since 1 month

Disturbed sleep since 1 month

Pain in lower limbs and knees since few months

Shortness of breath since 1 month

HISTORY OF PRESENT ILLNESS:

Loss of appetite since 1 month 

Disturbed sleep since 1 month

pain in lower limbs and knees since few months

HISTORY OF PAST ILLNESS:

Patient is a k/c/o HTN since 2 years and is on irregular medication

Patient is not a k/c/o dm, epilepsy, asthma, cad

H/O 2 PRBC transfusion 10 to 15 days back

PERSONAL HISTORY :

Diet- mixed

Appetite-lost

Sleep-disturbed

Bowel and bladder movements- regular

Addiction : No addictions, 

Consumes palm wine occasionally

FAMILY HISTORY: 

Not significant

GENERAL EXAMINATION:

No Pallor , icterus, cyanosis, clubbing,lymphadenopathy, edema

SYSTEMIC EXAMINATION:

CVS: S1,S2 heard, no murmurs heard 

P/A: Soft, Non-tender

CNS: No abnormalities seen.

PROVISIONAL DIAGNOSIS:

Chronic renal failure