Clinical case:- Bilateral leg swelling in a 30-year-old male

[nour]

Bilateral leg swelling in a 30-year-old male

HISTORY OF PRESENT ILLNESS

A 30-year-old male with no significant medical history presented to the ED complaining of three days of bilateral leg swelling that had progressed up his thighs, as well as facial and hand swelling. The face and hand swelling had resolved, but the leg swelling remained. He denied shortness of breath, chest pain, cough, fevers, chills, dysuria, hematuria, decreased urination, recent sore throat or abdominal pain. He denied similar episodes in the past. He took no medications. He denied alcohol or illicit drug use, and smoked three cigarettes per day. Family history was significant for hypertension. His fluid and food intake were reported as normal.

PHYSICAL EXAMINATION

GENERAL APPEARANCE: The patient appeared well developed, well hydrated and in no acute discomfort.
VITAL SIGNS
Temperature 98.2◦F (36.8◦C)
Heart rate 84 beats/minute
Blood pressure 160/113 mmHg
Respiratory rate 18 breaths/minute
Oxygen saturation 97% on room air
HEENT: Unremarkable.
NECK: Supple, no jugular venous distention.
CARDIOVASCULAR: Regular rate and rhythm without rubs, murmurs or gallops.
LUNGS: Clear to auscultation bilaterally without rales, rhonchi or wheezes.
ABDOMEN: Soft, nontender, nondistended.
EXTREMITIES: Examination of the hands and face did not reveal edema, whereas examination of the lower extremities demonstrated pitting edema from the feet up through the pre-tibial region to the knees bilaterally (Figure 1). Mild edema was noted to the mid-thighs bilaterally.
A peripheral intravenous line was placed, and blood was sent for laboratory testing. While awaiting the laboratory test results, a clear, yellow urine sample was obtained, and a bedside dipstick reagent test demonstrated 4+ protein.

What is your diagnosis?




Figure 1 Lower extremities of a 30-year-old male with bilateral
leg swelling for three days.

Members may check the correct answer file posted below

[abuhassan]

renal failuer

[drhomo]

it cant be RF

[dr.bayan]

RPGN in pt with renal failure

[dawn]

Kidney disease

[dr.bayan]

nephrotic syndrome

[mezza]

nephrotic syndrome

[mackmaine]

A 65 years old male Asian driver complained of sudden shortness of breath for an hour, no fever, no cough, no diarrhea, no vomiting, no chest pain. He had diabetes for 11 years and myocardial infarction for 5 years. PE: BP 170/105mmHg, moist rales in both lungs, especially in the base, HR 120bpm, no murmurs, regular S1 diminished. ECG showed old anterior myocardial infarction.
*What is the probable diagnosis for this patients?
*Why do you make such diagnosis? Your reasons?
*Write down the treatment for this patient briefly?

[Liljana]

nephrotic syndrome

[RomanMn]

Для пополнения оборотных средств в сфере микрокредитования и расширения сферы деятельности (выдача денежных средств в кредит, для физических и юридических лиц, под залог электроники, золотых и ювелирных изделий, любого транспортного средства, недвижимости) в определенном субъекте РФ, частное лицо, принимает денежные средства в качестве инвестиций по Договору Займа:
• Срок размещения: 3, 6, 9 или 12 месяцев;
• Начисление процентов 7% в месяц;
• Размер вклада от 200.000 руб.;
• Выплата % ежеквартально.
Способ внесения: через систему мгновенных банковских переводов, электронных платежей, наличными при встрече, на банковский счет (на указанное лицо и указанным способом по договору).
Способ выплат: по желанию вкладчика (указывается в договоре).
Цель инвестирования: получение выгодного (по сравнению с банковскими депозитами) гарантированного дохода.

Гарантии: в качестве гарантий могут служить:

• Договор Займа на конкретное лицо;
• Документы, подтверждающие оплату и получение денежных средств;
• Договор на кредитование физического или юридического лица;
• Залог (золотые и ювелирные изделия, автотранспортное средство, недвижимость, - обычно это составляет по оценочной стоимости не более 40-70% от рыночной цены).

Готов к плодотворному сотрудничеству, обсуждению и разрешению любых вопросов.
Контакты:
E-MAIL - region.smol@gmail.com
Телефон при необходимости по переписке.
При желании готов к встрече в г. Москва, с Вами лично, либо с Вашим представителем.

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