Neurological & Male GI Disorders

Case 1
Chief Complaint (CC)	“It burns when I urinate”
History of Present Illness (HPI)	A 68-year-old Caucasian male who reports having an increase in the frequency of urination with urgency for the last 5 days. He also presents dysuria and nocturia.
PMH	Benning prostatic hyperplasia was diagnosed 3 years ago, UTI 6 months ago, and Lithotripsy left kidney 10 years ago. No issues after treatment
Drug Hx	Rosuvastatin 20 mg Olmesartan 20 mg
Subjective	Fever and chills, no changes in vision or hearing, no difficulty chewing or swallowing. No sexually active, nocturia, or dysuria. Yellowish urethral secretion.
Objective Data
VS	B/P 150/96; Pulse 89; RR 16; Temp 99.4; Ht 6,1; wt 180;
General	well-developed male, with no acute distress
HEENT	Atraumatic, normocephalic, PERRLA, EOMI, arcus senilus bilaterally, conjunctiva and sclera clear, nares patent, nasopharynx clear, edentulous.
Lungs	CTA AP&L
Card	S1S2 without rub or gallop S4 present
Abd	No tenderness normoactive bowel sounds x 4;
Rectal exam	Warm, swollen, and painful prostate gland
Integument	good skin turgor noted, moist mucous membranes
Neuro	No obvious deformities, CN grossly intact II-XII

Answer the below questions. Note that all your responses should apply to your specific patient from your assigned case study.

What other subjective data would you obtain?

What other objective findings would you look for?

What diagnostic exams do you want to order?

Name 3 differential diagnoses based on this patient presenting symptoms.

Give rationales for each differential diagnosis.

What teachings will you provide?