318 10 yo M presents with tea-colored urine VS: T 36 C (97.5

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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
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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