65-year-old male presents to your clinic with frequent urination


65-year-old male presents to your clinic with frequent urination. He complains of painless, frequent urination approximately every 45 minutes to an hour for the past 5 months. He states he hates visiting doctors because they always try to find something wrong with him. His wife made him this appointment, but he thinks his problem is just because he is getting older. He denies any pain on urination or any blood in the urine. He also denies any difficult voiding. No foul odor is in the urine or discharge from the penis. He has tried to reduce his liquid consumption, but it has not made much of a difference. He denies any pelvic pain or rectal pain. He has not had any labs done in the past 5 years. Also, he has not had a physical done in 10 years. Physical exam reveals an African American male in no apparent distress. Abdomen is soft, nontender, no masses or distensions on palp. No hepatosplenomagaly. DRE reveals an enlarged, firm, smooth, symmetrical prostate. Provide the most likely diagnosis based on the HPI and PE. In addition, provide your interpretation of the cues found in the assessment. List at least 3 possible differential diagnoses and justify your rationale. Develop therapeutic plan options based on quality, evidence-based clinical guidelines.

Answer

Genitourinary Conditions

            Genitourinary conditions make a strong case for standard clinical reasoning. For males, genitourinary conditions could share similar symptoms. For the 65-year-old who presents with frequent urination, clinical reasoning as informed by physical examination (PE) and history of presen... Gxxxxxxxxxxxx Cxxxxxxxxx&xxxx;&xxxx;&xxxx;&xxxx;&xxxx;&xxxx;&xxxx;&xxxx;&xxxx;&xxxx;&xxxx; Gxxxxxxxxxxxx xxxxxxxxxx xxxx x xxxxxx xxxx xxx xxxxxxxx xxxxxxxx xxxxxxxxx. Fxx xxxxx, xxxxxxxxxxxxx xxxxxxxxxx xxxxx xxxxx xxxxxxx xxxxxxxx. Fxx xxx 65-xxxx-xxx xxx xxxxxxxx xxxx xxxxxxxx xxxxxxxxx, xxxxxxxx xxxxxxxxx xx xxxxxxxx xx xxxxxxxx xxxxxxxxxxx (PE) xxx xxxxxxx xx xxxxxxx xxxxxxx (HPI) xxxxx xxxxxx xxx xxxx xxxxxxxx xxxxxxxxx.Txx Mxxx Lxxxxx Dxxxxxxxx&xxxx;&xxxx;&xxxx;&xxxx;&xxxx;&xxxx;&xxxx;&xxxx;&xxxx;&xxxx;&xxxx; Cxxxxxxxxxx xxxx xxx HPI xxx xxx 65-xxxx-xxx xxxxxxxxxxx xxxxxxxx xxxxxxxxx xxxx xxx xxxxxxxx xxxx xxxxxx xxx xxxxxxxx xxx xxxxxx xxxxxxxx, xxx xxxx xxxxxxxx xxxxxxxxx xx Bxxxxx Pxxxxxxxx Hxxxxxxxxxx (BPH). Lxxxxxx xx xx., (2019) xxxxxxxxx xxxx xxx xxxxxxxx xxxxx xxxxxxxxxxxxxxx xx xxx xxxx xxxxx. Hxxxxxx, xx xxxxxxxx xxxxxxxx, xxxxxxxxx xx Lxx &xxx; Kxx (2017), xxxxxxxx xxxxxxxx xxxxxxxxx xx xxx xxxxxxxxxxxxx xxx BPH xx xxxxxxx xx xxx xxxxxxxx xxxxx xx x xxxxx-xx xxxx'x xxxxxxx xxxxxx. Txxx, xxx 65-xxxx-xxx’x xxxxxxxx xxxxxxxxxxx xxxxxxxx xxxxxxx xxxx xxxxx xxxxxxx, xxxxxxx xxxxxxxxxx xxxxxxxxx, xx xxx xxxx xx xxx xxxxxx xxxx xx xxx xxxxxxxx xxx xxx BPH.Pxxxxxxx Dxxxxxxxxxxx Dxxxxxxxx&xxxx;&xxxx;&xxxx;&xxxx;&xxxx;&xxxx;&xxxx;&xxxx;&xxxx;&xxxx;&xxxx; Oxxxxxxxxx xxxxxxx (OAB) xx xxx xxxxx xxxxxxxxxxxx xxxxxxxxx xxxxx xxx xxxxxxxxxxxxxx BPH. OAB xx xxxxxxxxx xx x xxxxxx, xxxxxxxxxxxx xxxx xx xxxx xxxxx, xxxxx xxxx xxxxx xxxxx xx xxxxxxxxxxxx. Sxxxxx xx xxxxx xxxxxxxxx xxxxxxxxxxx xxxxx xx xx xxxxxxxxxxxx xxxxxxxxx xx xx xxxxxxxx xxxxxxxx (Mxxxxxxxxxxx xx xx., 2019), xxxxx xxxxxx xx xxx xxxxxxxxxxxxx xx x xxxxxxxxx xxxxxxxxx xx xxx xxxxxxxx. Txx xxxxx xxxxxxxxxxxx xxxxxxxxx xxx xx xxxxxxxx. Txx xxxxxxxxxxxx xxxxxxx xx xxxxxxx xx xxx xxxxx xxxxxx xxxxxxxxx xx xxxxxxx xx xxxxx, xxxxx xxxxx xxxxx xxxxxxxxxxx xxxxxx xxxx xxx xxxxxx, xxxxxxx xxxxxxxx xxxxxxxxx.

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