22F GIDDINESS AND PAIN IN RENAL ANGLE 1 YEAR

 

6/11/2026

THIS PATIENT DATA WAS GATHERED BY ROLL NO 23 BATCH 2023 AS PART OF HIS COMPETENCE BASED LEARNING EVALUATION PORTFOLIO PREPARATION 

 * Date: 06-11-2026

 * Name: [REDACTED]

 * Age: 22 Y / [REDACTED]

 * Mobile: [REDACTED]

 * Address: [REDACTED]

 * Occupation: [REDACTED]

Clinical Notes:

 * C/O (Complaints):

   * Pain in renal angle since 1 year

   * Giddiness since 1 year

 * H/O / P/T:

 * Giddiness, renal angle pain, SOB (Shortness of Breath)

 * Past History:

   * K/o HTN since 1.5 months

   * No H/o D.M

   * No H/o TB

 * Personal History:

   * Diet: Mixed

   * Appetite: Good

   * Sleep: Adequate

   * B.O (Bowel Habit): Regular / Normal

   * Pt has history of taking Sirdan Tab

 * Family History:

   * No significant family history

 * General Examination:

   * Pt is conscious / oriented (or relevant clinical abbreviation as written)

 * General Physical Examination

   * Pt is conscious

   * PI, CC, LE: G 0 0 0 0 +

   * Edema: Present

 * CVS (Cardiovascular System)

   * S_1, S_2 (+)

   * No murmur

 * RS (Respiratory System)

   * Bilateral Airway Entry...

 * Abdomen

   * Soft, Non-tender

 * Vitals

   * PR: 85/min

   * BP: 170 / 80

   * SpO_2: 98%

   * Temp: 98.4 °F

 * Provisional Diagnosis

   * Chronic Kidney Disease Stage-V

Here is a series of Socratic questions tailored for medical students based on the clinical case details:

1. Presenting Complaints & Pathophysiology

 * The patient is a 22-year-old female presenting with renal angle pain and giddiness for 1 year.

   * Question: How does a chronic process affecting the kidneys (such as Chronic Kidney Disease Stage-V) directly or indirectly cause giddiness (dizziness) over a prolonged period? What systemic complications should you suspect?

   * Question: What anatomical structures are being stretched or inflamed when a patient experiences pain localized specifically to the renal angle?

2. Vitals & Cardiovascular Correlation

 * Her vitals show a blood pressure of 170/80 mmHg with a known history of hypertension for only 1.5 months, alongside lower limb edema.

   * Question: In a young patient presenting with severe hypertension and CKD Stage-V, is the hypertension more likely the cause or the consequence of the renal disease? How would you differentiate between renal parenchymal disease and renovascular hypertension?

   * Question: Why is lower limb edema present alongside hypertension in this clinical picture? What fluid and electrolyte imbalances are at play?

3. Clinical Reasoning & Staging

 * The provisional diagnosis is Chronic Kidney Disease (CKD) Stage-V.

   * Question: What specific clinical parameters or staging criteria distinguish CKD Stage-V from earlier stages of renal impairment?

   * Question: Given that she is only 22 years old, what differential diagnoses (e.g., congenital anomalies, glomerulonephritis, IgA nephropathy, systemic lupus erythematosus) should be prioritized in your investigation?

4. History Taking & Medication Review

 * Her personal history notes a previous prescription for Sirdan (tizanidine, a muscle relaxant).

   * Question: How might the use of certain medications or the underlying uremic state contribute to symptoms like giddiness or altered blood pressure regulation?

   * Question: What critical investigations (such as serum creatinine, eGFR, urinalysis, and renal ultrasound) would you order next to confirm the provisional diagnosis and assess renal function/size?