CASE SCENARIO:-

*A 28 yrs old female came to opd chief complaints of pain at right hypochondrium, pain in the left flank, shortness of breath, tiredness(since 2 years).

HISTORY OF PRESENT ILLNESS:-

*Patient was apparently asymptomatic 15yrs ( i.e in 2007 ) she had complaints of loss of weight and appetite for which she was diagnosed as pulmonary tuberculosis and on started on anti tubercular therapy .But she discontinued the treatment and she was kept of 8 months ATT and in 2020 she developed low back ache for which she was diagnosed as renal calculi.now she came to our hospital with c/o left flank pain , dyspnoea grade 2,one episode of hematuria.

HISTORY OF PAST ILLNESS:-

*TB in 2007

*Hematuria on 25th May 2022

TREATMENT HISTORY:-

*Homeopathy for SOB.

PERSONAL HISTORY:-

*Diet is mixed.

*Appetite is normal.

*Bowel movement is regular.

*Bladder movement is normal.

*Micturition normal.

*No known allergies.

*No addiction to alcohol and smoking.

FAMILY HISTORY:-

*No H/O of HTN, DM.

*Father having gastric problems.

*Father having hernia.

MENSTRUAL HISTORY:-

*Periods are irregular since 2 months.

PHYSICAL EXAMINATION:-

*No pallor, icterus, cyanosis, clubbing.

*No lymphadenopathy.

*B.P- 110/70 mmHg

*Temperature- 98.6 F

*Pulse rate- 66per min.

PROVISIONAL DIAGNOSIS:-

*Right upper lobe fibrosis secondary to old pulmonary tuberculosis.

INVESTIGATIONS:-

#Haemogram:-

Hb-12.1

TLC-8800

N/L/E/M/B-58/34/4/4/0

MCV-85

MCH-28

PLC-1.58

#LFT:-

Total bilirubin-1.4

Direct bilirubin-0.28

AST-24

ALT-26

ALP-138

Total protein-6.8

Albumin-4.0

#RFT:-

S.Creatinine-0.7

B.Urea-29

S.electrolytes-

     Na+=141

     K+=4

     Cl-=100

#CUE:-

Sugar/Bile salts/Bile pigments/Albumin- Nil

Pus cells- 2-3

RBC/Crystals/Casts- Nil

Chest X-Ray:-