1 / 19

Case 1 Urology Clinical Interactive Teaching Session

Case 1 Urology Clinical Interactive Teaching Session. You are the intern on-call and was called to see a patient in the ER Good evening I am Dr. X What is your name?. Chief complaint: Unable to pass urine. AUR VS Anuria. History of present illness: 55y old Duration=24h

eljah
Download Presentation

Case 1 Urology Clinical Interactive Teaching Session

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Case 1Urology Clinical Interactive Teaching Session

  2. You are the intern on-call and was called to see a patient in the ER • Good evening • I am Dr. X • What is your name?

  3. Chief complaint: • Unable to pass urine. • AUR VS Anuria. • History of present illness: • 55y old • Duration=24h • He has suprapubic pain.( Desire to micturate) • For the last few months he noticed gradual decrease of his stream, hesitency, drippling • Nocturia x 5, frequency q1.5h • No dysuria or urgency.

  4. Hematuria: • 3m ago • Once • Total • No clots • No associated pain • No no loin pain no fever

  5. One episode of AUR following cholecystectomy about 4y ago. • It was managed by in& out Foley catheter • Postoperative failure to pass urine • Dehydration VS retention • PMH: • Cystoscopy for stone bladder 10y ago. • UH repair many years ago • DM X 15y, remote CVA, Parkinson disease • No hypertension, IHD, Bilh., T.B. or Br.Asthma • SI: • Low back pain

  6. SH: • Widow and newly remarried. • Smokes 1ppd • Works in a tire shop • FH: Brother died of prostate disease. • Medication: ASA, Otrivin for common cold, buscopane, drug for his Parkinsonism • Drug Allergy: • Summery: 55y old male patient presented with 24h history of acute urinary retention

  7. DD: • BPH • Ca prostate • Stone bladder or urethra • Neurogenic bladder • Drug induced • Urethral stricture

  8. Examination • General: • Pain • Signs of Uremia • Pulse • BP • Temp • Abdomen

  9. SPT

  10. Examination: • General • In pain, pulse, BP, temp, • Look for signs of uremia • Abdomen: • suprapubic area, loin, liver. • Back: No tenderness. • Genitalia: Hernia • PR: • anal tone, size, consistency, surface, tenderness, mucosa.

  11. Management: • Insert urethral catheter. • Suprapubic tube.

  12. Investigations: • Urinanalysis, urine C&S.

  13. C&S 1) Sensitivity 2) Safety 3) Costs 4) Oral or not 5) Frequency

  14. Renal profile: • creatinine=189 • PSA= 8.8 • US: • kidney • pelvis • TRUS • Urethrogram

More Related