GENITOURINARY BLOCK CASE 1 A 50-year-old malay man came to accident and emergency unit with history of unable to urinate.

Further history reveals that he had increasing urinary hesistancy and decrease force of his urine stream for several months. He also complaint of sensation of incomplete bladder emptying. On rectal examination, you find smooth, firm, elastic enlargement of the prostate and examination of lower abdomen reveals sign of distended bladder. Investigations reveals increase urinary sodium excretion, increase BUN, hyperkalaemia, hypocalcaemia, hyperphosphataemia and anaemia. 1. 2. 3. 4. 5. 6. Describe clinical anatomy of prostate State your diagnosis State 3 risk factors of the disease you stated above State the pathogenesis of disease you stated above What are the complications of the disease you stated above State 1 emergency management in this patient

CASE 2 40 years old malay man with history of insulin dependent diabetes mellitus has not taking his daily insulin injections for 1 week. He presents to the emergency room with deep, regular, sighing respiration, abdominal pain, vomiting and signs of severe dehydration. Arterial blood gases are as follows low blood pH, low HCO3, and decreased pCO2. 1. 2. 3. 4. 5. State abnormalities that can be seen in this patient blood gas Based on arterial blood gases, state your diagnosis State your clinical diagnosis Name the sign of deep, sighing breathing State the formula for anion gap calculation

RAPID FIRE QUESTION 1. 2. 3. 4. Classify the causes of acute renal failure Classify chronic renal failure Describe briefly the anatomy of left kidney Explain the pathophysiogy in relation to renal failure below a) Oliguria b) Uraemia c) Hypertension d) Proteinuria e) Hypoalbunaemia 5. Describe the pathogenesis of renal osteodystrophy 6. State 5 defense mechanism of urinary tract

CASE 3 A 25-year-old Chinese lady presents to emergency room with fever, severe flank pain and costovertebral angle pain. Further history reveals that she is sexually active and had a 2-week history of burning pain while urinating and has had to take more frequent visits to the bathroom. Investigations confirm the diagnosis of pyelonephritis 1. 2. 3. 4. Classify pyelonephritis, state the cause and pathogenesis State the criteria used in choosing antibiotics in this patient State 3 most common organism that cause pyelonephritis State 3 expected findings in this patient urinalysis

CASE 4 A 60 years old hospitalized man being treated with long-term IV gentamicin suddenly develops nauseous and oliguric. PE reveals development of rales and a new arrhythmia. An ECG shows peaked T waves with prolonged QT segment. Investigation reveals hyperkalaemia, hyperphosphataemia, azotemia and elevated urine sodium. Urine samples shows muddy brown cast 1. 2. 3. 4. 5. CASE 5 A 10 years old girl presented complaining of eye swelling. You remember this children from 2 weeks ago when she was seen for pharyngitis. Lab findings include azotemia, hematuria and red cell cast in the urine, and an increase ASO antibody titer 1. 2. 3. 4. What does increase ASO antibody titer tells you? State your provisional diagnosis State the pathogenesis of this disease Outline the management in this patient Describe anatomy of tubules State your diagnosis What are other causes of disease you stated above Why is there ECG abnormalities? State criteria of nephritic and nephritic syndrome