Makerere University Renal Disease and Mens Health Issues Paper Topic: Renal Disease and Men’s Health Issues (respond to only one of the topics) Topic 1

Makerere University Renal Disease and Mens Health Issues Paper Topic: Renal Disease and Men’s Health Issues

(respond to only one of the topics)

Topic 1

K.N. is a 24-year-old woman who presents to the family practice clinic complaining of sudden urgency to urinate, back pain, frequent urination, and pain with urination. Symptoms began approximately 48 hours ago. She awoke from sleep with urgency and suprapubic discomfort 2 nights ago. Her urine now has a strong odor and a cloudy appearance. She has an allergy to Bactrim.

What are some appropriate questions to ask the patient?
What are three differential diagnoses for the patient?
What physical examination would you perform?
What diagnostics would you include?
Create an evidenced-based plan of care. Include pharmacological and non-pharmacological treatments.

Urine dipstick results: Color, dark yellow, specific gravity 1.035, ph 5.5, protein (-), Ketones (-), Bilirubin (-), Trace blood, Leukoesterase (+), Nitrites (+), Urobilinogen (-)

Topic 2

Mr. J.R. is a 73-year-old man who presents to the office with a 3-day history of nausea, vomiting, and diarrhea. He also has some weakness and dizziness and a bothersome metallic taste in his mouth. The patient is pale and sweaty. He had been fine until 3 days ago when he began to experience severe nausea several hours after eating out at a restaurant. He has taken Kaopectate several times without relief. Since yesterday he has had six to seven watery stools.

What are some appropriate questions to ask the patient?
What are three differential diagnoses for the patient?
What physical examination would you perform?
What diagnostics would you include?
Create an evidenced based plan of care. Include pharmacological and non-pharmacological treatments.

Urine dipstick: Clear, pale yellow urine, Microscopy was negative for cells, casts, pigments and crystals, SG 1.019, (-) bacteria, (-) glucose, (-) protein, WBC 1/HPF with no eosinophils, RBC 1/HPF, Na concentration= 14 meq/L, Osmolality= 769 mOsm/kg H2O. Na 144 meq/L, K 4.7 meq/L, Cl 111 meq/L, HCO3 57 mg/dL, Cr 2.6 mg/dL, Glucose random 155mg/dL, Ca 9.1 mg/dL, Phos 4.1 mg/dL, Mg 2.8 mg/dL, Alb 4.3 g/dL, H

Topic 3

Mr. E.D. is a 63-year-old retired mail carrier who presents to his primary care provider for a routine follow up for his hypertension. He complains of a 4-day history of dysuria, increased urinary frequency, and nocturia. He states that he has been having fever and chills. Denies any recent sexual activity. On examination, his temperature is 99.5 F., pulse 75 and regular, respiratory rate 16 and unlabored, and blood pressure 135/85. He does not appear acutely ill and is in no apparent distress. Examination of the abdomen was normal. A digital rectal exam revealed a moderately enlarged, firm, non-tender prostate gland. He states that he has severe urgency and difficulty urinating.

What are some appropriate questions to ask the patient?
What are three differential diagnoses for the patient?
What physical examination would you perform?
What diagnostics would you include?
Create an evidenced-based plan of care. Include pharmacological and non-pharmacological treatments.

Topic 4

T.R. is a 51-year-old male who presents to his PCP with the complaint of having some problems in the bedroom. He states that for the past 7 months he has only been able to achieve temporary, partial erections that are insufficient for intercourse. This issue has caused T.R. and his wife to have some marital issues. He was diagnosed with hypertension. He is currently taking Hydrochlorothiazide 25 mg daily.

What are some appropriate questions to ask the patient?
What are three differential diagnoses for the patient?
What physical examination would you perform?
What diagnostics would you include?
Create an evidenced-based plan of care. Include pharmacological and non-pharmacological treatments.

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