75 years old female pt 
knonw to have   dM   fir the last 15  years 
HTN    for the last   15   years
CHF 



befeore  one week she   developed    sob  and she  foudn to have creatinine     4.9 


medication
medication 
asa 
plavix 
liponil 
mepral a
cacium 
alfacal 
lasix   40 mg once 