Case history
Case history #1
A 55-year-old man presents with a long history of uncontrolled hypertension, increased urinary albumin excretion, and benign prostatic hypertrophy. He reports a past history of bladder infections and surgery on the bladder as an infant. For the past 1 to 2 weeks he has been feeling ill, and he noted some blood in his urine last night. On physical exam the patient is in mild distress, with blood pressure 150/90 mmHg, regular pulse 84 beats per minute, and temperature 98.6°F (37°C). The patient has no costovertebral angle tenderness.
Case history #2
A 60-year-old woman presents with a long history of poorly controlled type 2 diabetes mellitus, musculoskeletal pains attributed to fibromyalgia, and depression. She has been seen several times with a variety of vague complaints; today, she states that she has lost her appetite and has been feeling feverish. Her lower back is bothering her more than ever, especially on the right, and her usual pain medication is not helping. Temperature is 100.5°F (38°C), weight is 8 lb lower than on her last visit, and physical examination is remarkable for right costovertebral angle tenderness.
Use of this content is subject to our disclaimer