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* NBME 12 BLOCK 2 Q 32- ???Neurogenic bladder or BPH
 #680287  
  agboolalai - 06/06/12 12:35
 
  The patient's history shows that past medical history is UNREMARKABLE, prostate is moderately and symmetrically enlarged WITHOUT NODULES. Symptoms only started 12hours ago....
Could this be a neurogenic bladder- inability to void urine?
 
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* Re:NBME 12 BLOCK 2 Q 32- ???Neurogenic bladder or
#2675188
  agboolalai - 06/06/12 14:45
 
  anyone?
 
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* Re:NBME 12 BLOCK 2 Q 32- ???Neurogenic bladder or
#2675190
  neuralcrest - 06/06/12 14:48
 
  it is neurogenic bladder cos it is rapid onset, bph would be more insidious in its onset. wish u added the patient's age.  
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* Re:NBME 12 BLOCK 2 Q 32- ???Neurogenic bladder or
#2675201
  crazy4step1 - 06/06/12 14:58
 
  Hi! I took NBME last weekend. I marked neurogenic bladder but they consider it wrong in the feedback.
Some have the correct answer?
 
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* Re:NBME 12 BLOCK 2 Q 32- ???Neurogenic bladder or
#2675290
  agboolalai - 06/06/12 16:31
 
  the patient's age is 75yrs, other options there are BPH, bladder cancer, urolithiasis and RCC.
Someone also claimed to make urolithiasis and got it wrong, I also feel it is neurogenic bladder but crazy4step1 just said it is wrong. pls any suggestion?
Thanks.
 
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* Re:NBME 12 BLOCK 2 Q 32- ???Neurogenic bladder or
#2677059
  jlx - 06/09/12 18:33
 
  32. A previously healthy 75-year-old man is brought to the emergency department by his wife because of a 12-hour history of confusion. Medical history is otherwise
unremarKable. He is stuporous. Physical examination shows a mar1c.edly distended bladder up to the umbilicus. The prostate gland is moderately and symmetrically
enlarged without nodules. Laboratory evaluation shows a serum creatinine concentration of 10.5 mgfdL and a serum urea nitrogen (BUN) concentration of 130 mgfdL.
Urinalysis shows no abnormalities. Which of the fo llowing is the most likely diagnosis?
o A) Benign prostatic hyperplasia
o B) Bladder malignancy
o C) Neurogenic bladder
o 0) Renal cell carcinoma
o E) Urolith iasis

BPH???
 
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* Re:NBME 12 BLOCK 2 Q 32- ???Neurogenic bladder or
#2677093
  soprax - 06/09/12 20:07
 
  I took the exam online ...... It is BPH  
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* Re:NBME 12 BLOCK 2 Q 32- ???Neurogenic bladder or
#2677099
  ryhm - 06/09/12 20:25
 
  is it possible that the BPH has created a vesical globe, which got infected, and created a septic choc? explaining the confusion and the renal insufficiency?  
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* Re:NBME 12 BLOCK 2 Q 32- ???Neurogenic bladder or
#2677150
  agboolalai - 06/10/12 00:27
 
  thanks Sopras I guess in questions like this, it is better to choose the commonest cause of a presentation which in this case is BPH.  
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* Re:NBME 12 BLOCK 2 Q 32- ???Neurogenic bladder or
#2677157
  matth87 - 06/10/12 00:41
 
  electrolyte imbalance or increased BUN can cause confusion.

Uremia:
Fatigue[3]
Peripheral neuropathy[3]
Decreased mental acuity[3]
Seizures[3]
Anorexia[3]
Nausea[3]
Decreased taste and smell[3]
Cramps[3]
Restless legs,[3] potentially due to decreased muscle membrane potential[3]
Sleep disturbance[3]
Coma[3]
 
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* Re:NBME 12 BLOCK 2 Q 32- ???Neurogenic bladder or
#2856037
  thomaszhang - 03/20/13 08:57
 
  but there's one point in the question: Serum Cr:10.5 BUN:130, so BUN/Cr  
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