General medicine

Osce questions- Risk factors for BPH -men over 50 years of age -men who are obese -men whose fathers have BPH -some men with erectile dysfunction Features of BPH -incomplete emptying of bladder -increased frequency of urination -urgency of urination -nocturia -weak stream of urine Diagnosis: Symptom score index: first step to diagnose BPH   Digital rectal examination:   Patient lies on his side or bend over.The doctor inserts the gloved finger in to rectum to feel the back of the prostate gland. The doctor is looking for enlargement, tenderness, lumps or hard spots. Urine analysis:         •  Urine tests for blood, protein, signs of infection, sugar .         •post void residual volume         •uroflometry          Scans:         •ultrasound         •cytoscopy         •MRI and CT Blood tests:         Prostate specific antigen Confirmatory test:         Transrectal ultrasound        Multiparametric MRI   Learning points       A

OA 63 year old male patient residence of Marripeda bangla came with Cheif Complaints :- Complaints of increased frequency of passage of urine since one month. Complaints of fever since 1 month Back pain since 15 days Vomiting Since one day History of presenting illness Patient was apparently aAsymptomaticsymptomatic one month back then he developed burning micturition which was insidious in onset, no aggravating and relieving factors   Complaints of increased frequency of urine approximately 20 times a day and increased passage of urine during night Times approximately 5 times since 1 month. fever was insidious in onset, gradually progressive ,intermittent , associated with chills and rigors, low grade, relieved on medication Back pain sudden in onset dull aching which started after fall from the accident. Complaints of vomiting since one day, non projectile, non bilious 4 episodes, food as content Complaints of shortness of breath since 5 days Patient feels Dehydrated since 5 days No