39 years old patients with chief complaints of abdominal pain ,fever , burning micturition

  A 39year old male patient cooking master by occupation resident of miryalagudam presented with chief complaints of fever since 7days, pain in the abdomen since 7days, burning of urine during passage and increased in frequency of urine passage since 7days

History of presenting illness:

The patient was apparantely asymptomatic 3 years back then he was diagnosed with type 2 diabetes and he is on medication. Since 1 month on routine checkup he had uncontrolled sugar levels of 300mg.now presented with pain in the abdomen at umblicus and lower abdomen since 7days which is squeezing type of pain and continuous in nature not associated with nausea, vomiting, abdominal distension and loose stools.

Burning micturition since 7days, increase in frequency sometimes he pass urine in his clothes before he reached bathroom.

Low grade Fever since 7days which is continuous in nature, associated with headache not associated with chills and rigor.

Cough since 2 days back.

Past History

he is a known case of diabetes mellitus since 3 year's

No h/o hypertension, asthma, tb, epilepsy

PERSONAL HISTORY :


diet :mixed


Appetite :decreased


Sleep :disturbed


Bowel movements :normal


Bladder movements:increased frequency


Weight loss is present due to exercise


No addictions


FAMILY HISTORY :not significant


GENERAL EXAMINATION :patient is examined with an informed concent in a well illuminated room.


Patient is conscious, coherent and cooperative moderately built and moderately nourished.


No pallor


No icterus


No clubbing


No kolionychia


No lymphedenopathy


No Edema 


Vitals :


Temperature :100f


RR:20cpm


PR:86bpm


BP:150/100mmhg


GRBS:274mg/dl


SYSTEMIC EXAMINATION :


CVS:S1and S2 Heard


RS:BAE+


Abdomen examination :


Shape of abdomen :obese


Tenderness :present at Lower abdomen and b/l loin tenderness


Palpable mass :no


Hernial orifice :normal


Free fluid :no


Bruits :no


Liver:not palpable


Spleen :not palpable


Bowel sounds :heard


Cns examination :


Level of consciousness :conscious


Speech :normal


Signs of meningeal irritation :absent


Cranial nerves: normal


Motor system :normal


Sensory system :normal




Reflexes :KAP:normal


Cerebellar signs:finger nose in coordination :present


Knee heel in coordination :present


Provisional diagnosis :pyelonephritis or cystitis


Lab reports :












Treatment :






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