318 10 yo M presents with tea-colored urine VS: T 36 C (97.5
7030_Section_3 11/5/04 4:10 PM Page 318 318 CASE 66 HX PE D DX 10 yo M presents with tea-colored urine and periorbital edema. He had a fever and sore throat one week ago. He also complains of malaise, weakness, and anorexia. VS: T 36°C (97.5°F), BP 140/85, HR 88, RR 18 Gen: Periorbital edema, pallor Lungs: WNL CV: WNL Abd: WNL Ext: Edema around ankles • Cryoglobulinemia • IgA nephropathy • Membranoproliferative glomerulonephritis • Poststreptococcal glomerulonephritis (PSGN) Other Urinary Symptoms CASE 67 HX PE D DX 70 yo M complains of waking up 4–5 times a night to urinate. He also has urgency, a weak stream, dribbling, and he needs to strain to initiate urination. He denies any weight loss, fatigue, or bone pain. He also has a sensation of incomplete evacuation of urine from the bladder. VS: T 37°C (98.5°F), P 78, BP 140/85, RR 14 Gen: NAD Neck: WNL Lungs: WNL CV: WNL Abd: WNL Ext: WNL Rectal exam: Enlarged, nodular, nontender, rubbery prostate gland • Benign prostatic hypertrophy • Bladder cancer • Bladder stones • Bladder trauma • Chronic pelvic pain • Cystitis • Neurogenic bladder • Prostate cancer • Prostatitis • Urethral strictures • UTI HX PE D DX 39 yo M complains of sudden-onset fever and chills, urgency and burning on urination, and perineal pain. His symptoms started after he underwent urethral dilatation for stricture. VS: T 37.3°C (99°F), P 65, BP 101/64, RR 16 Gen: No acute distress Lungs: WNL CV: WNL Abd: Suprapubic tenderness GU: Genitalia WNL Rectal exam: Asymmetrically swollen, firm, markedly tender, hot prostate • • • • • • • • • H IG H-YI E LD CASES CASE 68 Acute cystitis Anal fistulas and fissures Epididymitis Obstructive calculus Orchitis Prostatitis Pyelonephritis Reiter’s syndrome Urethritis
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