What is the final diagnosis

Reference no: EM133658079

Assignment:

A 50 y.o. male presents with c/o urinary frequency. He claims, "All I seem to do is go to the bathroom-I'm going to put a desk and TV in there." He says it has been going on for months and cannot recall exactly how long, but he voids every 1 to 2 hours during the day and then must get up to void through the night. He does not have any other urinary symptoms and has not noticed any change in the appearance or color of his urine, including no visible blood. Patient has a history of type 2 diabetes for the past 10 years, which he admits has been poorly controlled. He occasionally checks his blood glucose at home, and it is usually "closer to 200 than 100." He takes metformin 1000 mg BID and liraglutide daily. He pretty much eats what he chooses. "I know better, but I live alone and have bad habits." His review of systems is positive for tingling and discomfort in his feet. He tires easily but says he really does limited activity. He denies blurred vision, rashes, dizziness, chest pain, palpitations, shortness of breath or cough, abdominal pain, diarrhea, constipation, or joint pain.

Family History

Father, diabetes, heart disease, kidney disease
Mother, heart disease
Brother, heart disease

Psychosocial History

An accountant who works in an office setting where he is sedentary. Smokes approximately one-half-pack per day and drinks four to five beers weekly. Diet consists largely of fast food. Has tried decreasing his intake of fluids, but that does not seem to make a difference in his voiding.

Physical Examination

Vital signs: T 98.8, BP 154/94, HR 76, A1C 9.0, HT 70, WT 210 lbs.
Laboratory results: Urine negative for WBC, RBC, +1 glucose, -ketones.
General: Overweight, well-groomed, alert and oriented, in no apparent distress.
Eyes: PERRL, EOMs intact, alignment symmetrical, conjunctiva pink and moist. Funduscopic exam some narrowing and hard exudates. Disc normal and no neovascular changes noted. Remainder of HEENT normal. Neck full ROM, no bruits.
CV: RR&R, S1/S2, no murmur or extra sounds.
Respiratory: Lungs slight decreased breath sounds but no crackles, wheezes.
Abdomen/GU: Protuberant and soft. Normal bowel sounds, no suprapubic or other abdominal tenderness, no masses, no bruits. Rectal exam negative for occult blood, prostate symmetrical and smooth, slightly enlarged.
MS: Full ROM, strength equal and normal.
Skin: No lesions.

Questions

1. What three conditions would be considered in your differential diagnosis, with most likely condition listed first (with rationale)?

2. What further history, further examination, and diagnostic studies are warranted to explore your differential diagnosis?

3. What is the final diagnosis?

Reference no: EM133658079

Questions Cloud

Segregation and affirmative action : Discuss 4 of the major Supreme Court decisions of the 20th centuries bearing on race, segregation, and affirmative action.

Explain the causes and consequences of world war : Explain the causes and consequences of World War I. Explain the causes and consequences of World War II.

Discuss medical errors : I want you to discuss medical errors and whether they are historically just considered an unavoidable consequence of healthcare.

First industrial revolution and second industrial revolution : What were the similarities and differences between the First Industrial Revolution and Second Industrial Revolution? How did new inventions affect economy?

What is the final diagnosis : What three conditions would be considered in your differential diagnosis, with most likely condition listed first (with rationale)?

Explain two major arguments in support of the constitution : Explain two major arguments in support of the Constitution given by the Federalists, represented by Alexander Hamilton

Analyze the political-economic and ideological reasons : Analyze the political, economic, and ideological reasons why the United States began the early 20th century foreign policy expansion across the world.

Assessing a client who has tension pneumothorax : A nurse is assessing a client who has tension pneumothorax. Which of the following findings is a sign of distress that may compress the heart?

Should be a piece that resonates with you personally : Should be a piece that resonates with you personally. 1st sentence introduces poem, poet, speaker, and conflict/dramatic situation.

User Account

All Pages