Author Question: Bill is a 49-year-old black male who presents to the ED with complaints of fever, malaise, oliguria, ... (Read 54 times)

littleanan · **on:** Jun 27, 2018

Bill is a 49-year-old black male who presents to the ED with complaints of fever, malaise, oliguria, anorexia, and exquisite flank pain. Patient also states he had several episodes of hematuria. Patient denied any history of diabetes, hypertension, or high cholesterol . Blood work showed his BUN and creatinine levels were exceedingly high and the electrolytes were grossly abnormal. Non-contrast helical CT was done and confirmed there were several kidney stones in the ureters. One was quite large on the right side and there were concerns about blockage and the potential for hydronephrosis. Patient was admitted for pain control and further work up treatment. The large kidney stone in the right ureter was causing a blockage and the patient underwent ESWL to break up the stone. Unfortunately, he did develop hydronephrosis, though with careful monitoring, it resolved.

Dx: Hydronephrosis with ureteral stricture

First-listed/principal diagnosis: ________
Secondary diagnosis: ________
Fill in the blank with correct word.

Question 2

Maurice is 56 years old and it was apparent that he was very anxious when he arrived at urgent care. He was hesitant to tell the receptionist why he was seeking treatment, but then finally told her that he had an erection just would not go away. Physical exam by the PA showed that he did, indeed have an erect penis. Maurice relayed that he had tried Viagra for the first time tonight and was initially very pleased with the results. However, after achieving orgasm, the erection did not resolve. The patient has a past medical history that is very uncomplicated. He denies any hypertension and DM. He takes no prescription medication and only uses the occasional over-the-counter medication, usually aspirin for a headache, which is seldom. There is no urologist on call at the urgent care center, so the patient was transferred to the local ED for further treatment.

Dx: Priapism due to Viagra

First-listed diagnosis: ________
Secondary diagnoses: ________
Fill in the blank with correct word.

cici · **Reply #1 on:** Jun 27, 2018

Answer to Question 1

First-listed/principal diagnosis: ________
Answer: Hydronephrosis with ureteral stricture N13.1

Secondary diagnosis: ________
Answer: None

Answer to Question 2

First-listed diagnosis: ________
Answer: Priapism N48.33

Secondary diagnoses: ________
Answer: Adverse effect of peripheral vasodilator T46.7X5A