my pt 42 old male named Vikesh

year
calwaal hindu by religion peon by occupation
at to CPRH
residing Gandhinagar came

7
days W 210-
ago
i yellowish discolourat" in : 3wks
eyes

Pt was
Apparenty asymptomatic 3 wks

when his boss noticed yellowish

ago
discolourath in his eyes , which was

in onset ,
insidious gradual in
progression
w no
aggravating and no
relieving factors ,
w

no dinmal variath

associated with abdominal distension /fullness of abdomen

breathlessness
in
swelling legs
dark coloured stools
red urine
pain in abdomen
-

rehlo-
2 no ho cough ,
fever

no n/o chest pain

non/o oliguria
no ho

h/o
no daytime sleepiness
 /0
no
itching

Past h/o-
no of similar complaints in past
2 previous admissions in CPRH

, HT
of DM I , TB & Anhma
no ho -

no blo of sx
any

Personal ho-
Disturbed sleep cycle
① appetite
B/B- unaltered
Diet-mixed .

L
-

addict"-
alcohol - name -
hatbhatti + desi

guanting 9X 90m) =
360m)
<x quarters
- -

Concentrat
412) 2144 you
=
90 % pdiala of
Peg alcohol
Durat" -
Since 30
you
intake who food
-

CAGE- > O besharam

-
 Tobacco-
half Pack
everyday since 30Xrs.

smoking -

mint
E
1 per day since zoyas

Cigarette PXI = 0 .
05 X30

= 1 .
5

family ~

not
significant
n/u

Socioeconomic up) -

sumary
t
Provisional
32 old M-Vikes Galwade,
year
Diagnosis-
Chief
complaints of yellowish discolourat",
associated w abd distension -

,
breathlessness ,
bla
swelling of
legs ,
dark coloured stook
red arine .
W2 previous admissions
chronic
for similar
complaints and
alcoholic > Tobacco abuser , smokien
since 30 Yas .

↓
D = * koholic lives disease-
General examinate
-

Conscious , well oriented

BP =
120/80
Consentr , adequate light
and
exposure
Pulse = 56

Temp afebria

RR = 24/min

Interns ~

Medal edema-Pitting type-Gradeknee

2
B
upto
-

PCCL =

Central line

head to toe examinat"

-

of liver failure
signs
-

ictems .
Dilated veins
-

Alopecia
madorous
fetor hepalics
Spider naevi
parotid swelling

subconjuctival naemorm

KF
ringS
Gynaecomasbi
asterixias
Caput medusae
Palmar engumes
Muscle atrophy
contract
Dupytren's