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1. IDENTIFICATION DATE OF ADMISSION 11/1/17 Age 46 SEX M MRN Address Admission Dx P1 = Rt forearm cellulitis P2 =CAP with parapneumonic effusion P3= Cystitis + mild Hydronephrosis P4= Mod. Anemia 2 nd ?IDA P5= Hyperkalemia 1 9/22/2024

2. SUBJECTIVE EVIDENCE A 46 yrs old male patient presented with right forearm swelling of six days duration which associated with low grade intermittent fever. He has also history of flank pain, frequency, urgency and dysuria of 6 days duration. He has history of dry intermittent cough and easy fatigability of one week duration. Otherwise No hx of urine color change. No hx of headache and LOC no HX of body swelling No hx of chest pain No hx of DM and HNT 9/22/2024 HU CHMS SOM Dpt of Internal medicine 2

3. Objective Evidence 3 GA stable V/S BP = 103/65 PR = 98 RR = 20 T = 36.7 SPO2 = 93% HEENT Pc & NIS LG N o LAP, RS Decreased air entry over 1/3 of chest bilateraly and dullness over same area CVS S1& S2 well heard no murmur no gallop Abdomen FULL abdomen that moves with respiration GUS No CVAT MSK There is swelling with tenderness over right upper forearm IGS No pallor CNS GCS 15/15 COTPP

4. Complete blood count Clinical Chemistry Test Item Result  Result  Test Item  WBC WBC= 5.9k Neu =66.1 L = 20 1.06x10^3/L, Ne: 10.4% U/A=UNREVEALING OFT RBC 6.5x10 12 /L CR= 0.88/0.87 HCT 28.9 59.9 Urea= 76/66.8 HGB 9.2 20.1g/dL ALT= 10.1/20 MCV 74.4 84.3 fl Serum elect Na= 136/130 AST=38.5/12 K=6.09/6.15 Bilirubin T= 0.254 D= 0.017 CL=112/106 MCHC 37.1 VIRAL MARKER NEGATIVE RDW 18 Serum albumin=2.12 Platelets 168k 201X10^3 HBA1c=5.5 50 4

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8. What was done Ceftriaxone 1gm iv bid Azithromycin 500mg/3days Tramadol 50mg iv tid R.insulin 10 iu iv with 60ml of D40 qid Follow v/s closely 9/22/2024 HU CHMS SOM Dpt of Internal medicine 8

9. Plan Ecg and electrolite 9/22/2024 HU CHMS SOM Dpt of Internal medicine 9