renal / gu cases

Question 1

ed hx ex

Answer 1

duration, severity, morn/noctural erections, stress, depression, trauma, incontinence, gynecomastia, loss of body hair, meds, med Hx (vascular rts, prior sx, liver, thyroid, neuro dz), etoh, drugs

Question 2

ed ix

Answer 2

genital ex, rectal ex, glucose, cbc, testosterone levels

Question 3

40s M, impotence htn, atenolol, diabetes w insulin

Answer 3

medication related ed, ed caused by htn or dm, psychogenic ed, peyronie’s dz

Question 4

dyspareunia hx ex

Answer 4

duration, timing, assoc sx (vag discharge, rash, painful menses, gi, hot flashes), lube enough, menopause?, libidio, sex hx (trauma/violence), endometirosis, pid, abdo/pelv sx

vitals, abdo, pelv ex

Question 5

dyspareunia ix

Answer 5

pelvic ex, wet mount, koh prep, cervical clutlures, lh/fish, us pelvis, laparoscopy, endometrial bx

Question 6

50s, painful intercourse, LMP 9 mo ago, hot flashes

Answer 6

atrophic vaginitis (w menopause), endometriosis, cervicitis, depression, domestic violence

Question 7

37 f dysparenuia, ,can’t conceive, dysmeorrhea

Answer 7

endometriosis, cervicitis, vaginismus, vulvodynia, PID, depression, domestic violence

Question 8

vag discharge hx ex

Answer 8

amt, color, consistency, odor, onset/duration, vag burning/pain/pruritis, sex activity (condoms?), tampons/douches, LMP, Hx past, Stds.

ex: vitals, abdo, pelvic ex

Question 9

vag discharge ix

Answer 9

pelvic ex, wet mount/koh pprep/whiff test, ph vag fluid, cervical cultures

Question 10

thin, gray-whte, foul smelling discharge

Answer 10

bacterial vaginosis, candidal or trichomonal vaginitis, cervicitis (chlam, gono)

Question 11

thick, white, cheesy, odorless discharge, vag itching

Answer 11

candida, bac vag, vaginitis (trich)

Question 12

malodorous, profuse, throthy, greenish vag discharge, intense vag itching, discomfort

Answer 12

trich vaginitis, candida, bac vaginosis, cervicitis (chlam, gono)

Question 13

hematuria hx ex

Answer 13

amt, duration, clots, pt in stream (initial, terminal, all throughout), assoc sx (b, renal colic, dysuria, irritiave voiding). meds, vigourous exercise, trauma, smoking, stones, ca, easy bleeding, bruising/purpura

ex :vitals, lymph, abdo, gu/rectal, ext

Question 14

hematuria ix

Answer 14

gu/pelvic, ua/urine cytology, bun/cr, psa, cbc, pt/ptt, us renal/bladder, ct abdo pelvis, cystoscopy

Question 15

painless hematuria, elderly smoker, painter

Answer 15

bladder ca, rcc, nephrolithiasis, acute glomnephritis, prostate ca, coag disorder (factor 8 Ab)

Question 16

35 m painless hematuria, hx kidney dz

Answer 16

polycystic kidney dz, nephrolithiasis /urethlithiasis(?), acute glomneph (ie igA nephr), uti, coag disorder, bladder ca

Question 17

55 m flank pain, blood urine, no dysuria. weight loss / fever, flank mass

Answer 17

rcc, bladder ca, nephrolithiasis, acute glomneph, pyeloneph, prostate ca