manegment section.ppt

7/28/2019 manegment section.ppt

1/17

Management session

on bladder cancerBy:- mesfin semunigus

Lidiya chanyalew


2/17

Identification

Name Yaya Ahmed

Age 60

Sex M

Religion muslim

Ethnicity Oromo

Occupation Farmer

Address combolcha,oromia

Admission date 15/05/04


3/17

Chief compliant

reddish urine discoloration of 04 months


4/17

?


5/17

History of present illness

The patient was relatively health 4 month back at whichtime he fall to ground on his abdomen while he was

walking.

Following the accident he has no history of loss ofconsciousness, abdominal pain, distention & no loss ofdesire to urinate.

After a day, he started to notice reddish discoloration of

the urine which was intermittent at onset. it is painless& he passes through out the stream.

But at the end it become frank red.


6/17

Cont

He has hesitence, nocturia of 2x and sense ofincomplete urination

The patient has no difficulty on micturation,dysuria, incontinency, frequency or urgency.

He has veggie type of supra pubic & bilateralflunk pain which is non radiating.

He has no extremity or face swelling.


7/17

He has no chest pain , cough, hemoptosis. Nobone pain.

No history of vomiting, diarrhea, constipation,yellowish eye discoloration & skin pruritis.

He has associated symptoms dizziness, vertigo,easily fatigability, loss of appetite & lostunspecified amount of weight.


8/17

He has smoking history 3 pack year

He has no personal & family history of DM,hypertension, cardiac disease, asthma

8 years back abdominal surgery was done for acompliant of chronic vomiting (??GOO)


9/17

Physical exam

General appearance

chronic sick looking, not in cardio-pulmonary distress.

V/S

stable


10/17

HEENT

pink conjunctiva and non icterous sclera.

poor dental hygiene and dental care.

LNs ; no LAP RS;no flaring of analzy, cyanosis, use of accececary

muscles.

central trachea, no mass or tenderness

resonant percussion note

vesicular breath sound. no added sound.


11/17

CVS;

all superficial accessible arteries palpable

JVP ;not raised.pericardium

quite, apical impulse not visible PMI is

at 5th

ics MCL.S1 & S2 heard no murmur, nogallop.


12/17

Abdominal exam Inspection; shaphoid ,move with respiration, hernial sites

are free. There is vertical midline surgical scar.

Auscultation; normoactive bowel sound, no brow heard

Palpation; no tenderness no mass, organomegaly ispalpated

Percussion:-tympanic percussion note

PR Intact anal sphincter tone. no blood, ulcer Normal sized prostate, rubbery inconsistence,

Rectal mucosa move over it,

Medial sulcus is palpable & upper border is reachable.


13/17

GUS: no CVA & supra pubic tenderness

MSS: no joint deformity,

Integmontery: no rash, edema CNS: conscious, oriented to time, place &

person


14/17

Investigation

Hct 38,

Blood group B+

Cr 0.96

BUN nornal

SGPT & SGOT normal

u/a Albumin; +1

Bld; +4

Microscopy ; too muchRBCs/HFM

u/s : irregular soft tissuemass in the bladder.

CXR

IVP

Cyctography

Cyctoscopy Urine cytology

Flow metery

CT of pelvic


15/17


16/17


17/17

manegment section.ppt

Documents

Transcript of manegment section.ppt