ASSESSMENT 4 HISTORY: Describe the history you just obtained from this patient.

Include only information (pertinent positives and negatives) relevant to this patients problem(s). HPI: THE PATIENT MOTHER CALLED C/O 7 YO MALE CHILD WITH BEDWETTING, ONSET MANY YEARS AGO. NO ALLEVIATING FACTORS. NO LATE NIGHT EATING OR DRINKING. URINATES APPROXIMATELY A CUPFUL 3-4 NIGHT A WEEK. DISPLAYS URINARY URGENCY AT LEAST 2 X A WEEK. DENIES FEVER, HEMATURIA ABDOMINAL PAIN OR CONSTIPATION OR NOCTURIA. NO ENVIRONMENTAL CHANGES, DOES WELL IN SCHOOL. MOTHER DENIES ANY NEUROLOGICAL SYMTOMS. ROS: SLEEPS 8 HOURS A NIGHT, NO SNORING, NO WEIGHT LOSS, NO SPECIAL DIETS. ALLERGIES: NKDA MEDS: NONE PMH: CHICKEN POX AS A SMALL CHILD PHS: NONE FH: FATHER HAD A HISTORY OF ENURESIS AS A CHILD SH: LIVES WITH MOTHER AN FATHER, UNCOMPLICATED FAMILY LIFE, NO RECENT MOVES, OR STRESSES. BIRTH HISTORY: VAGINAL DELIVERY, UNCOMPLICATED, MOTHER RECEIVED PRENATAL CARE DIET HISTORY: REGULAR FOOD, MULTIVITAMINS IMMUNIZATIONS: UTD DEVELOPMENTAL HISTORY: LAST CHECK UP 1 YEAR AGO, NORMAL, WEIGHT, HEIGHT VISION/HEARING MILESTONES PHYSICAL EXAM: Describe any positive and negative findings relevant to this patients problem(s). Be careful to include only those parts of examination you performed in this encounter. PHYSICAL EXAM: NONE DATA INTERPRETATION: Based on what you have learned from the history and physical examination, list up to 3 diagnoses that might explain this patients complaint(s). List your diagnoses from most to least likely. For some cases. Fewer than 3 diagnoses will be appropriate. Then, enter the positive or negative findings from the history and physical examination (if present) that support each diagnosis. Lastly, list initial diagnostic studies (if any) you would order for each listed diagnosis (e.g. restricted physical exam maneuvers, laboratory tests, imaging, ECG, etc. Diagnosis #1:NOCTURNAL ENURESIS HISTORY FINDING(S) PHYSICAL EXAM FINDING(S) -BED WETTING FROM MANY YEARS NONE -URINARY URGENCY 2x A WEEK -URINATES 3-4 NIGHTS A WEEK

Diagnosis #2:CONSTIPATION HISTORY FINDING(S) -BED WETTING FOR MANY YEARS -URINATES 3-4 TIMES A WEEK -URINARY IRGENCY 2x AWEEK Diagnosis #3:CYSTISIS HISTORY FINDING(S) -URINARY URGENCY 2x A WEEK -URINATES 3-4 NIGHTS A WEEK -BED WETTING FOR MANY YEARS Diagnostic studies: -PHYSICAL EXAM -U/A -ELECTROLYTES -GLUCOSE -BUN

PHYSICAL EXAM FINDING(S) NONE

PHYSICAL EXAM FINDING(S) NONE