Tales of the Urology Service

On the schedule for yesterday's hospital rotation was Surgery/Urology. After meeting our precepting physician at the Operating Theatres we were led to the Male Surgical Ward to conduct a history and physical on a pleasant 57 year old male complaining of painful and dribbling urination, as well as frank hematuria (blood in the urine) for the past 4 days. We spent an inordinate amount of time on, and delved deep into the man's history of present illness, past illnesses, social history, etc. in a vain attempt to find a surgical reason for his problems. Despite our precepting physician's initial glimmer of hope that the gentleman may need a minor, 15-minute surgical procedure, unfortunately once again we did not get to scrub in for any surgery. Instead, he was diagnosed with clot retention, and his management would consist of foley catheter placement. The cause of the clot was thought to be a bleeding prostate, which formed a blood clot, causing urine in the bladder to back up, as well as the blood in the urine.

After our hospital rotation, it was back to campus for an evening lecture: OSHA Blood-Borne Pathogens. I'm even in a foreign country, and I still can't escape the grasp of OSHA. Kinda sucked though, since I am certified to teach the class, and two of the people I am sharing a car with had current certifications and we could have skipped the class, except the 4th person sharing the car had never been through the class, so we all had to stay. Oh well, it gave me a good opportunity to register to take the USMLE I, and rid myself of a nice chunk of change ($695 to be exact.) Now that I've registered, I guess that means I should start studying for it… :evil:


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sonja Says:

wow that sucks..having to pay that much..and to take a test!

Carsten Says:

Oh that’s nothing… Step II is over a thousand… maybe even closer to two thousand.

And the review courses for it run $5,000 - $7,000…

 
 
Subaqua Sternal Rubs » Blog Archive » Tales of the Urology Service, Part II Says:

[…] This afternoon it was back to the Male Surgical Ward for Part II of our Urology rotation. Lo and behold, the same patient who we gleaned a history from last week was still on the ward, albeit in a different bed. This time, we were instructed to preform a complete, yet quick (1o minutes) physical exam. (Being newbies, we are a little slower, trying to make sure we don’t miss anything, but managing to anyways.) Of note was a large, smooth, palpable mass that moved with respiration and spanned the entire left side of his abdomen. Evidently, a CT scan showed a possible renal clear cell carcinoma (kidney cancer), that may have invaded the Inferior Vena Cava (the major blood vessel collecting blood from the lower part of the body and returning it to the heart). Unfortunately, the type of cancer and spread to other sites in this patient carries a very poor prognosis. The urologist estimated that mean survival would be about 6 months, possibly a year. […]

 

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