Case 14 - 80 year old male came to the opd with chief complaints of burning micturition and pain in the umbilicus

Hi, I am Yeddula Vishnu Priya, 5th semester medical student. This is an online e log of patient's de-identified health data shared after taking his/her/guardian's signed informed consent. Here we discuss our individual patients problems through series of inputs from available global online community of experts with an aim to solve those patients clinical problem with collective current best evident based input.This elog also reflects my patient centered online learning portfolio

I have been given this case to solve in an attempt to understand the topic of " patient clinical data analysis" to develop my competency in reading and comprehending clinical data including history, clinical findings, investigations and come up with diagnosis and treatment plan

80 yr old male, unemployed from nampel came to opd with

Chief complaints of

nocturia which was around 5 times in one night

Burning micturition which was associated with pain in the abdomen

Dysuria since 1 day

Past history:

Patient was apparently asymptomatic before July 2021. Then he developed nocturia(5times /day), urgency, urgency incontinence, dribbling, poor stream for 2 months (June-sep of 2021). Patient went on acute retention of urine in sep 2021 and was catherized. He gives a history of voiding trial given 5 months back and failed and he was advised for surgery but he refused it. Hematuria was seen when he collected urine for urine examination. Dysuria since 1 day, 2 episodes of vomiting 2 days back. Glucose levels raised to 540 yesterday night

No history of fever, loss of appetite, loss of weight, turbiduria

Treatment history :

He is on medication for diabetis since 2 and 1/2 yrs

Personal history:

Married, unemployed, normal appetite, mixed diet, normal bowel, burning micturition, no known allergies

Alcoholic but stopped consumption since 2 yrs.

No significant family history

Examination :

General Examination :

Patient is conscious, coherent and coperative well built and well nourished.

No pallor, icterus, cyanosis, clubbing of fingers, lymphadenopathy, pedal edema

PERCUSSION: