Posted on: Monday, October 29, 2018 1:05:00 PM EDT
PBL#2pertains to the Urinary system, and can be found using the course link below.Same policies, procedures, rules,timeline, etc.The last PBL is due via SafeAssign link before 11:59pm on November 25th! No late submissions will be accepted.
A Rick, a 16-year old male, was admitted to the emergency room with severe pain because of trauma to his scrotum, testis and perineum. Upon questioning it was determined that Rick and his 2 other companions (who were also admitted for treatment) had attacked a classmate (John) because they didn't like the way he looked and acted in school. However, as the fight progressed, Rick and his companions quickly learned that John was a 5'th degree black belt in karate. Within a short time the fight was over, and John was the only one left standing.
Patient History
- Rick is 16-years old, Caucasian, and is 5 foot 1o inches and weighs 135 pounds.
- He has marks indicating that he has received stitches for moderate wounds on at least 5 previous instances. None of his wounds have been below the umbilicus.
Physical Examination
- The patient has considerable scrotal pain, discoloration and swelling.
- His temperature is 37 degrees Celsius.
- His pulse is 145, and his blood pressure is 140/98 .
The patient is admitted for observation and further testing.
After 24 hours the physician notes the following observations on the patient's chart:
- The patient has been unable to urinate. Repeated attempts to urinate has produced only a few drops of bloody urine.
- Preliminary X-ray results (as read by the attending x-ray technician) demonstrated no injury to the bony pelvis.
- The patient's temperature has been slowly, but steadily climbing, with the latest reading be 39 degrees C.
- A urologist and gastroenterologist have been called in for consultation.
- An abdominal lavage has produced negative results.
Utilizingsoundlogic, consider the following questions:
- What is your diagnosis, and why? Justify your answer with the patient’s signs/symptoms and scientific literature.
- Is the patient in any immediate danger? (Rationalize your answer).
- What is an abdominal lavage, and how is this test conducted? What are the possible results, and what would a positive or a negative result tell the attending physician?
- Are the kidneys still producing urine in this patient? Why or why not? If the kidneys are still producing urine, where is the urine collecting?
- If left untreated, what would be the long term affects for this patient?
- What basic anatomy should the attending physician review concerning this patient's case, and why?