| Symptoms
& History
Physical
Findings
Stop
& Think
Lab
and X-Ray
Differential
Diagnosis
The
Disease
Treatment
Conclusions
Quiz
& Evaluation |
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So
what do we do for Mr. Potter?
-
The problem
of multiple medical conditions is not that unusual with elderly patients.
-
Begin
treatment
of his CHF and pulmonary edema.
-
Given
the state of his renal function, he will almost certainly need some form
of renal replacement therapy i.e. peritoneal or hemodialysis. (This
may be the only way to get his vascular volume down.)
-
Decompress
his kidneys and hope some renal function can be salvaged. This will
likely involve cytoscopy of his bladder and possibly some degree of
resection of his prostate (TUR), with the installation of ureteral
stents.
-
A reasonable
amount of tissue from his prostate would allow us to develop a Gleason's
grade and score for his tumor.
-
Medical
treatment of his tumor and metastases by means of a medical
orchiectomy.
Mr. Potter
has just gotten a lot sicker.
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