Questions and Answers
What is the most appropriate action for a 52-year-old male with urinary frequency and an isolated right posterior lobe nodule?
Which term describes the characteristic concave or 'spoon-shaped' nails of iron deficiency anemia?
Which of the following is NOT a characteristic feature of nephrotic syndrome?
What is the most likely diagnosis for a patient with a history of recurrent bouts of uveitis, elevated serum calcium and uric acid levels, and bilateral hilar adenopathy?
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Which diagnosis is most likely for a 34-year-old female with symmetrical redness and swelling of small hand joints, symptoms worst in the morning, elevated ESR, and negative rheumatoid factor?
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What diagnostic study would be most helpful for a 27-year-old nulliparous female with a history of appendicitis and infertility?
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Study Notes
Urinary Symptoms and Prostate Exam
- A 52-year-old male presented with urinary frequency, hesitancy, and nocturia.
- Physical examination revealed a nontender, non-enlarged prostate with a single right posterior lobe nodule.
- Most appropriate action: Order an ultrasound of the prostate and a PSA level to rule out cancer, as isolated nodules suggest malignancy.
Iron Deficiency Anemia and Nails
- Characteristic nail symptom of iron deficiency anemia is koilonychia, described as concave or "spoon-shaped" nails.
- Clubbing indicates thickening of the nail bed, often associated with conditions like cystic fibrosis.
- Other terms: leukonychia and onycholysis are not relevant to this condition. Paronychia refers to nailbed infection.
Nephrotic vs. Nephritic Syndrome
- Hematuria is a defining feature of nephritic syndrome, not nephrotic syndrome.
- Nephrotic syndrome is characterized by:
- Proteinuria exceeding 3.5 g/day.
- Hypoalbuminemia and hyperlipidemia.
- Generalized edema due to decreased oncotic pressure.
Uveitis and Granulomatous Disease
- A patient with recurrent uveitis and elevated serum calcium and uric acid likely has sarcoidosis.
- Sarcoidosis commonly presents with hilar adenopathy and noncaseating granulomas.
- Associated laboratory findings include elevated Angiotensin-Converting Enzyme (ACE) levels.
Symmetrical Joint Swelling in Women
- A 34-year-old woman with symmetrical joint swelling of the hands and elevated ESR is likely suffering from rheumatoid arthritis (RA).
- RA can occur even with negative rheumatoid factor (RF); approximately 20% of patients may test negative.
- Conditions like systemic sclerosis and ankylosing spondylitis present differently and may involve distinct symptoms or joint patterns.
Evaluation of Infertility
- A 27-year-old nulliparous female struggling to conceive for two years, with a history of a misdiagnosed appendicitis leading to abscess formation, should undergo a hysterosalpingogram (HSG) to assess potential tubal scarring.
- HSG is preferred to evaluate patency of fallopian tubes in infertility cases.
- Other tests, such as TSH or pelvic ultrasound, are not as relevant for diagnosing causes of infertility in this context.
Asthma Attack Assessment
- A 14-year-old experiencing a severe asthma attack shows increased respiratory effort with accessory muscle use but lacks audible wheezing.
- A rapid heart rate of 160 beats per minute suggests significant distress and may indicate status asthmaticus, emphasizing the need for immediate intervention.
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Description
This quiz covers key clinical symptoms and physical examination findings in urology, including urinary symptoms related to prostate health, and nails indicative of iron deficiency anemia. It also delves into the differences between nephrotic and nephritic syndromes, focusing on their specific features and characteristics. Test your understanding of these important medical topics.
