osce and learning points

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
      Aceclofenac is contraindicated in kidney patients

Due to above mechanism aceclofenac causes constriction of blood vessels, decrease GFR .

Source:

https://www.urologyhealth.org/urology-a-z/b/benign-prostatic-hyperplasia-(bph)

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