The Renal Problem
Clinical Examination
Practical Clinical Questions
Pls. answer on separate sheets of papers with identification number only, NO NAMES.
Evaluation Criteria: Precise, Clear, Adequate in terms of content, and Followed Instructions.
1. Advice a 50-year-old adult male patient on the options of paraclinical diagnostic procedures for a more definitive diagnosis of microscopic hematuria in which the primary clinical diagnosis is tumor (60% probability) and the secondary diagnosis is stone (40% probability). DO THIS: Show to the patient a comparative analysis of INTRAVENOUS PYELOGRAPHY AND ULTRASOUND in terms of benefit and risk, assuming both procedures are available and the costs are practically the same. SPELL OUT the benefits and risks on a paper, not just in terms of pluses and minuses.
Benefits Risks
Intravenous Pyelography
Ultrasound
2. Advice Jessica Cruz, a 40-year-old female nonpregnant patient with first episode of urinary tract infection ( positive urinalysis; no urine culture done) on the choice of antibiotics for her treatment.
DO THIS: Show to Jessica a comparative analysis of Amoxicillin and Trimethoprim-Sulfamethoxazole in terms of benefit and risk, assuming availability and cost are the same. SPELL OUT the benefits and risks on a paper, NOT just in terms of pluses and minuses.
Benefits Risks
Amoxicillin
Trimethoprim-Sulfamethoxazole
3. Write a COMPLETE AND PROPER PRESCRIPTION (containing all the required elements and qualities of a prescription) for ONE antibiotics for Ms. Jessica Cruz. Give a fictitious number for any license that may be needed in the prescription.
4. Eduardo Queston, a 45-year-old male with sudden onset of severe colicky abdominal pain. Your diagnosis is ureteral colic secondary to stone. He is confined in the hospital. In his chart, write a PROPER AND COMPLETE ORDER (containing all the required elements and qualities of an order) for a drug to relieve Mr. Queston of the severe abdominal pain AS SOON AS POSSIBLE.
5. Write a brief referral note to a renal specialist for further management for Mr. Juan Ante, a 56-year-old male with chronic fatigue noted since 6 months ago. His BUN and Creatinine are 3x the normal range. He has been hypertensive for the past 10 years. Give a fictitious name of the renal specialist and specify whether he/she is a nephrologist or urologist. Also give a fictitious address.
6. Write a brief referral note to a renal specialist for further management for Ms. Janet Sioco, a 58-year-old female with on and off abdominal pain since 3 months ago. KUB-IVP shows dilated right ureter. No radiopaque nor radiolucent lesion seen. Give a fictitious name of the renal specialist and specify whether he/she is a nephrologist or urologist. Also give a fictitious address.
7. Describe step by step (chronological sequence required) in an outline form how you will insert a Fr. 16 Foley catheter into the urinary bladder of an adult female patient. DO THIS:
7.1 Illustrate the spatial relationship of the urethral meatus, vagina, clitoris, and anus.
7.2 Enumerate the materials you need for the procedure.
7.3 Outline the procedure from positioning of the patient to anchorage of the catheter.
ROJ@17nov6