prefinal paper 2

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An 80 year old male came to OPD with chief complaints of    Bilateral knee joint pains since 2 years Sob since 6 months Indigestion on and off since 5 months  HOPI: Patient was apparently asymptomatic 2 years back then he developed bilateral knee joint pains not associated with any swelling,restriction of flexion movement.pain aggrevates during walking and relieved on taking rest and medication.not associated with fever  Then he developed SOB since 2 months which is of grade-2.It is not associated with cough(before dry cough) It is associated with pedal edema which is pitting type upto ankle.It is increasing while walking and relieved on elevation of limb and during rest. not associated with palpations,chest pain,sweating,fever Not associated with decreased urine output,burning micturition. Then he developed indigestion with burning sensation after food intake.relieved on taking medication. It is associated with abdominal discomfort,bloating(on and off). It is not as...
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