20 yr old female Bilateral pedal edema

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A 20 yrs old female who is a house wife was brought to the casualty with the C/O

• B/L pedal edema since 1 months

 •Shortness of breath (grade 2-3 ) since 1 months,which is insidious on onset gradually progressive not associated with orthopnea /PND

•Decreased urine output since 10 days 

•Swelling of lips since 3 days

HOPI:-

Patient was apparently asymptomatic 11years ago,then her parents observed her eating more food, increased urine output on a regular check up she was  diagnosed with diabetes type -1(On insulin since then) 

2018-  Patient became drowsy and brought to the hospital , diagnosed with?DKA 

From then she is on MIXTARD 18UNITS MORNING,12UNITS NIGHT

•1 year ago ,she got married

• 6 months ago- She was brought to the hospital as she has C/O Fever , Not eating food for 5 days.Then she was diagnosed Hypertensive ,since then she is on Telma 40 mg 

•3 Months Ago , patient was diagnosed with UPT positive and had abortion 2 months ago as fetal cardiac activity is absent

• On 9/4/22- Patient was brought to hospital as she has 

C/O B/L pedal edema since 3 months, Pitting type 

 •Shortness of breath (grade 2-3 ) since 3 months,not associated with orthopnea /PND

•Decreased urine output since 10 days 

•Swelling of lips since 3 days

FAMILY HISTORY:

Maternal uncle's have DM-2

GENERAL EXAMINATION:

Pt is conscious, coherent, cooperative

Bp-150/90 mmHg

Pr-91bpm

Temp -98.5°F

SpO2- 91%@RA

GRBS -254mg% @admission

CVS : S1 S2 +, Apex beat : 5th ICS mid clavicular line.

RS : BAE +, Decreased breath sounds in Right infra axillary,midscapular ,infrascapular regions,No crepts 

CNS : NAD

P/A : Soft, no tenderness . Bowel sounds +

Pallor ++,Edema present in both limbs ,face ,abdomen