62  years old male pt 
known to have  ischemic heartd  dis3ase 
sp  pci  in  2016  and     second  stge  to  lab and mi 

smoker 


rferred from dr ashraf 



medication 
crestor   20 mg once 
tritace  2,5 
conor   5 mg ocne 
asa 1
nexium 



abdominal us  showed  right  kidney  14   cm  and left  kidney  13   cm 
 with  right  septated  renal cyst 


left    kidney  showed prominat  pyhramindal  system  and    
he has  fatty  liver  20 cm 


plan 
add   dee  dense 
add biosolve 
to do labs   r/o myeloma 
r/o   diabetic nephropathy