Neurological & Male Genitourinary Disorders

Neurological & Male Genitourinary Disorders

For this Discussion, you will take on the role of a clinician who is building a health history for one of the following cases. Your instructor will assign you your case number.

	Case 1	Case 2	Case 3
Chief Complaint (CC)	“It burns when I urinate”	“I had a severe headache yesterday with difficulty to speak”	“I have been having frequents headaches lately”
History of Present Illness (HPI)	A 68-year-old Caucasian male who reports to have increase on the frequency of urination with urgency for the last 5 days. He also present dysuria and nocturia.	A 64-year-old African American female who reports having a severe pulsatile diffuse headache yesterday with sudden difficulty to talk with last for about two hours. She did not seek medical attention. This morning she woke up with no problems but is here today due her husband advise.	A 25-year-old Hispanic female presents to your clinic with a headache located on right temporal area, pulsatile.
PMH	Benning prostatic hyperplasia diagnosed 3 years ago, UTI 6 months ago, Lithotripsy left kidney 10 years ago. No issues after treatment	Atrial Fibrillation, Hypertension. Is allergic to Non-steroidal Anti-inflammatory drugs Aspirin	Frequent headaches since I was 15, with menses.
Drug Hx	Rosuvastatin 20 mg Olmesartan 20 mg	Losartan 50 mg Xarelto 15 mg BID	Ibuprofen for Headaches
Subjective	Fever and chills, no changes in vision or hearing, no difficulty chewing or swallowing. No sexually active, nocturia, dysuria. Yellowish urethral secretion.	Feels Palpitations, joint pain with yesterday’s episode	Light makes headache worst Nausea associated with headaches. No vomiting, Headaches improve usually with rest, ibuprofen, and sleep, but it is annoying to have to sleep all-day
Objective Data
VS	B/P 150/96; Pulse 89; RR 16; Temp 99.4; Ht 6,1; wt 180;	B/P 131/80; temperature 98.2°F; (RR) 18; (HR) 84, irregular; oxygen saturation (PO2) 96%;	B/P 108/64; Pulse 86; RR 16; Temp 98.6;
General	well-developed male, no acute distress	well-developed female, no acute distress	25-year-old female appears well developed and well-nourished, healthy appearing, wearing dark glasses in a dim room
HEENT	Atraumatic, normocephalic, PERRLA, EOMI, arcus senilus bilaterally, conjunctiva and sclera clear, nares patent, nasopharynx clear, edentulous.	Atraumatic, normocephalic, PERRLA, EOMI, conjunctiva and sclera clear; nares patent, nasopharynx clear, good dentition.	no injection, anicteric, PERRLA, EOMs intact, without pain to movement; normal vision
Lungs	CTA AP&L	CTA AP&L	CTA AP&L
Card	S1S2 without rub or gallop S4 present	Irregular heart beat with normal rate	S1S2 without rub or gallop
Abd	No tenderness normoactive bowel sounds x 4;	No tenderness normoactive bowel sounds x 4;	benign, normoactive bowel sounds x 4;
Rectal exam	Warm, swollen and painful prostate gland	Non contributory	Non contributory
Integument	good skin turgor noted, moist mucous membranes	intact without lesions masses or rashes.	intact without lesions masses or rashes.
Neuro	No obvious deformities, CN grossly intact II-XII	No obvious deficits and CN grossly intact II-XII	Cranial nerves II to XII intact; sensation intact, DTRs 2+ throughout. Functional neurological exam is WNL

 

Once you received your case number, answer the following questions:

1. What other subjective data would you obtain?
2. What other objective findings would you look for?
3. What diagnostic exams do you want to order?
4. Name 3 differential diagnoses based on this patient presenting symptoms?
5. Give rationales for your each differential diagnosis.
6. What teachings will you provide?

• Your initial post should be at least 500 words, formatted and cited in current APA style with support from at least 2 academic sources. Your initial post is worth 8 points.

  Please utilize journal articles to support your answer.APA style imperative