For this Discussion, you will take on the role of a clinician who is building a health history for one of the following cases. Your instructor will assign you your case number.
Case 1
Case 2
Case 3
Chief Complaint
(CC)
“It burns when I urinate”
“I had a severe headache yesterday with difficulty to speak”
“I have been having frequents headaches lately”
History of Present Illness (HPI)
A 68-year-old Caucasian male who reports to have increase on the frequency of urination with urgency for the last 5 days. He also present dysuria and nocturia.
A 64-year-old African American female who reports having a severe pulsatile diffuse headache yesterday with sudden difficulty to talk with last for about two hours. She did not seek medical attention. This morning she woke up with no problems but is here today due her husband advise.
Fever and chills, no changes in vision or hearing, no difficulty chewing or swallowing. No sexually active, nocturia, dysuria.
Yellowish urethral secretion.
Feels Palpitations, joint pain with yesterday’s episode
Light makes headache worst Nausea associated with headaches. No vomiting, Headaches improve usually with rest, ibuprofen, and sleep, but it is annoying to have to sleep all-day
Cranial nerves II to XII intact; sensation intact, DTRs 2+ throughout.
Functional neurological exam is WNL
CASE study number 1 is the one you will be assigned to
Once you received your case number, answer the following questions:
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 your each differential diagnosis.
What teachings will you provide?
Your initial post should be at least 500 words, formatted and cited in current APA style with support from at least 2 academic sources. Your initial post is worth 8 points.
Please utilize journal articles to support your answer.APA style imperative
Answer preview
One of the differential diagnoses based on the patient’s symptoms includes urinary tract infection (UTI). This condition is common in men older than 50 years who experience an enlarged prostate or urethral structure. Symptoms entail frequent urination and abdominal discomfort. Studies indicate dysuria associated with high urine frequency is 75% predictive of a UTI (Bardsley, 2018). Secondly, kidney stones are another differential diagnosis. The main symptom of this condition is pain with urination. The patient had undergone Lithotripsy 10 years ago; hence if the stone reached the ureter or bladder, it might result in a burning feeling when urinating. Lastly, prostate cancer is a differential diagnosis since it may cause trouble passing urine, including burning.
