6411: Module # 6 Male GU / Urinary Disorders – Case Studies & Answers

 

Male GU / Urinary Disorders – Case Studies & Answers

 CASE STUDY # 1:

A 20 year old male is found to be hypertensive on regular physical exam (175/105). History in unremarkable, PE is normal except for an abdominal “bruit” on auscultation.

What is the Diagnosis?

 

 

CASE STUDY # 2:

Chief complaint (CC): A 47 year old white male enters the emergency room complaining of a sudden-onset, severe headache that is the “worst headache of his life”.

History of Present Illness (HPI): He was recently treated for recurrent urinary tract infections, which were attributed to an enlarged prostate gland.  He also describes slow-onset dull pain in his left flank together with blood in his urine. His father died of chronic renal failure, and his paternal grandfather died of cerebral hemorrhage.

Vital Signs (VS) 180/130.

Physical Examination (PE): palpable, nontender abdominal mass on both flanks & nuchal rigidity.

Labs: Urine analysis (UA) shows Albuminuria & microscopic hematuria.

Ultrasound shows no signs of urinary stones.

 

  1. What is the Diagnosis of the clinical presentation? (i.e. right now, and please be specific)
  2. What is the most commonrenal pathology related to this presentation?

 

 

 

CASE STUDY # 3:

CC: An 8 year old white male presents with an erythematous skin rash over the buttocks and legs together with joint pains and hematuria.

HPI: Three days before, he had complained of cough, coryza, low grade fever, and sore throat.  He has a history of allergy to dust and pollen.

VS:  hypertension.

PE:  palpable purpuric skin lesions over buttocks and legs; painful restriction of knee and ankle joint movement with swelling. (See picture)

 

Labs   CBC:  normal platelet count; normal coagulation tests.  Increased erythrocyte sedimentation rate (ESR); increased BUN and serum creatinine.

UA:  RBCs and RBC casts on urinary sediment.  Positive stool guaiac test.

What is the most common pathology related to this presentation?

Hint: this is not a renal pathology but the kidneys are the MC organs affected.

 

 

 

CASE STUDY # 4:

CC: A 47 year old black diabetic male complains of weight loss, progressive shortness of breath, and swelling of the lower legs and arms.

HPI: His past medical history is unremarkable

PE: Pallor; pitting edema in extremities; decreased lung sounds with crackles bilaterally in lower lung fields; periorbital edema; ascites.

Labs   UA:  proteinuria (> 3.5 g/24 hr); lipiduria with oval fat bodies and fatty and waxy casts in urinary sediment; hypoalbuminemia; hyperlipidemia

What is the Diagnosis?

 

ANSWER

 

 

CASE STUDY # 5:

CC:  A 5 year old white male presents with generalized edema and abdominal  distention, producing respiratory embarrassment.

HPI:  The child had an upper respiratory infection one week ago

VS:  normotension.

PE:  generalized pitting edema; free ascitic fluid in peritoneal cavity; shifting dullness  and fluid thrill present; normal fundoscopic exam.

Labs:  UA: 4+proteinuria; Blood: hypoalbuminemia; hypercholesterolemia

 

What is the Diagnosis?

 References 

CASE STUDY # 1:

A 20 year old male is found to be hypertensive on regular physical exam (175/105). History in unremarkable, PE is normal except for an abdominal “bruit” on auscultation.

What is the Diagnosis?

ANSWER

Renal Artery Stenosis. Suspect it in a young patient with unexplained hypertension. This is more of a cardiovascular case than renal……. Click the link below to purchase…..