Common Cases of Urology
- 1. Case No 1: A pregnant lady, 28 year old, presented to emergency department with nausea and vomiting, temperature: 39.5°C, rigor, right flank pain, and mild dysuria. What’s your provisional diagnosis? Write in brief broad lines of management (clinical picture, investigations, Treatment). Case No 2: A 4 year old girl presented by her mother to the physician with abdominal swelling discovered accidentally. On examination, the swelling was firm, felt in the Rt. lumber area, and by U/S it is a Rt. renal mass. Reviewing the history, the mother observed that her daughter had anorexia in the last few months and started to lose weight. 1) What is the possible diagnosis? 2) Mention the investigation needed to confirm the diagnosis. 3) Enumerate (names only) the DD of a flank mass in children. Case No 3: A male patient 25 years old, presented with painful scrotal swelling with discharging sinus posteriorly and beaded vas. PCR indicates TB infection. Write medical treatment (used drugs and its dose). Case No 4: A male patient, 65 year old, complaining of LUTS mainly in the form of weak stream and sense of incomplete voiding. Summarize complications of BPH and medical treatment. Case No 5: A 42 year old farmer, presented with Lt. testicular swelling that enlarges progressively over the last 3 months but without pain. On examination the Lt. testis is larger and heavier than the Rt. one with loss of testicular sensation. Abdominal U/S revealed enlarged para-aortic LNs. a. What is your provisional diagnosis? b. Enumerate Differential diagnosis.
- 2. Case No 6: A 57 year old male patient with a history of renal stone had an attack of renal colic together with significant heamaturia. IVP revealed an irregular filling defect in the renal pelvis & U/S revealed enlarged para aortic LNs. c. What is the probable diagnosis? d. What investigations needed to settle the diagnosis? Case No 7: A retired guy (65 year old), He used to walk for one hour duration in the early morning daily. He is receiving antihypertensive medication (captopril) He has good sexual desire but complaining of weak erection since one year. The conditions started by gradual onset and progressive course. Imaging the cavernosal arteries with color duplex Doppler ultrasonography revealed low velocity of blood flow due to atherosclerosis. Plan your treatment. Case No 8: A male youth, 16 year old, presented to Emergency Room with acute onset of painful scrotal swelling with nausea and vomiting for 5 hour duration. Physical examination revealed tender high-riding left testis. He gave history of similar previous episodes. a) What is your provisional diagnosis b) what differential diagnosis of this case?
- 3. Case No 9: A male patient, 35 year old, presented to general practitioner in rural health unit with severe colicky pain in right loin area of sudden onset and referred to Rt testis. Also, he had nausea and vomiting with positive history of similar attacks. Urine analysis revealed microscopic hematuria, Plain X- Ray (KUB) revealed a radio-opaque shadow in the course of pelvic part of Rt ureter. Ultrasound examination revealed mild Rt side hydronephrosis. In this emergency situation, what is suitable radiologic investigation you will ask for? Write differential diagnosis of radio-opaque shadow in this case Case No 10: A 17 year old man was brought in to emergency department after road traffic accident. On examination, doctors found a small scalp laceration and right flank bruising. A urine specimen showed gross haematuria. Write in brief broad lines of management and grades of renal injury. Case No 11: A lady 35 year old, presented with mild bilateral flank pain. BP was 160/100, creatinine 3.2 mg/dl, Ultrasound assessment revealed polycystic kidneys. Write in brief your advice.
- 4. Case No 12: A male patient 65 year old complaining of difficulty of micturation and hematuria, the cystogram of the patient is shown above 1) Describe and write D.D. of this cystogram. 2) What further investigations help to settle diagnosis? Case No 13: A 50 year old patient complaining of bilateral flank pain, part of plain X-ray (KUB) is shown here. a) What is abnormal finding can you detect? b) Write brief account on pathogenesis of infection stone
- 5. Case No 14: A 50 year old patient complaining of painless gross hematuria, IVU is done 1-Describe this shown part of IVU 2- What most single radiologic test for delineating a renal mass. Case No 15: Male patient 35 years old, complaining of bilateral lion pain, the reconstructed non enhanced spiral CT of the patient is shown above. 1) Describe the picture? 2) Enumerate the possible advantages of this imaging technique?
- 6. Case No 16: Male patient 35 years old, complaining of lt. lion pain, Part of the IVU of the patient is shown above. 1) Describe the picture? 2) DD of the lesion? Case No 17: A male patient 55 year old complaining of total hematuria, ultrasound picture of the bladder is shown. What are the investigations needed to settle the diagnosis?