Discussion 6 - Neurological & Male Genitourinary Disorders

Discussion 6 Neurological & Male Genitourinary Disorders

For this , you will take on the role of a clinician who is building a health history for :

 Chief Complaint
(CC) “It burns when I urinate” 

 History of Present Illness (HPI)A 68-year-old Caucasian male who reports to have increase on the frequency of urination with urgency for the last 5 days. He also present dysuria and nocturia. 

 PMH Benning prostatic hyperplasia diagnosed 3 years ago, UTI 6 months ago, Lithotripsy left kidney 10 years ago. No issues after treatment.

 Drug HxRosuvastatin 20 mg
Olmesartan 20 mg 

 Subjective
Fever and chills, no changes in vision or hearing, no difficulty chewing or swallowing. No sexually active, nocturia, dysuria.
Yellowish urethral secretion. 

 VSB/P 150/96; Pulse 89; RR 16; Temp 99.4; Ht 6,1; wt 180; 

 General well-developed male, no acute distress 

 HEENT Atraumatic, normocephalic, PERRLA, EOMI, arcus senilus bilaterally, conjunctiva and sclera clear, nares patent, nasopharynx clear, edentulous. 

 Abdominal No tenderness normoactive bowel sounds x 4; 

 Rectal examination Warm, swollen and painful prostate gland 

 Integumentary good skin turgor noted, moist mucous membranes 

 answer the following questions:

1. What other subjective data would you obtain?
2. What other objective findings would you look for?
3. What diagnostic examination do you want to order?
4. Name 3 differential diagnoses based on this patient presenting symptoms?
5. Give rationales for your each differential diagnosis.
6. What teachings will you provide?