OTHER URINARY SYMPTOMS

Question 1

60 yo M presents with nocturia, urgency,
weak stream, and terminal dribbling. He
denies any weight loss, fatigue, or bone
pain. He has had two episodes of urinary
retention that required catheterization.

Answer 1

Benign prostatic hyperplasia
(BPH)
Prostate cancer
UTI
Bladder stones

Rectal exam
UA
CBC, BUN/Cr, PSA
U/S—prostate (transrectal)

Question 2

71 yo M presents with nocturia, urgency,
weak stream, terminal dribbling,
hematuria, and lower back pain over the
past four months. He has also
experienced weight loss and fatigue.

Answer 2

Prostate cancer
BPH
Renal cell carcinoma
UTI
Bladder stones

Rectal exam
UA
CBC, BUN/Cr, PSA
U/S—prostate (transrectal)
CT—pelvis
IVP

Question 3

18 yo M presents with a burning
sensation during urination and urethral
discharge. He recently had unprotected
sex with a new partner.

Answer 3

Urethritis
Cystitis
Prostatitis

Genital ± rectal exam
UA
Urine culture
Gram stain and culture of
urethral discharge
Chlamydia and gonorrhea PCR

Question 4

45 yo diabetic F presents with dysuria,
urinary frequency, fever, chills, and
nausea over the past three days. There is
left CVA tenderness on exam.

Answer 4

Acute pyelonephritis
Nephrolithiasis
Renal cell carcinoma
Lower UTI (cystitis, urethritis)
UA

Urine culture and sensitivity
CBC, BUN/Cr
U/S—renal
CT—abdomen