Instructions
You are a medical student on placement in general practice. Your next patient is Bao Nguyen, 78, brought in by his daughter with new wetting. His blood results from two days ago are below.
Take a history from the patient and his daughter
Perform an abdominal, genital and rectal examination
Outline to the examiner:
- Your findings
- Your interpretation of the results
- Your most likely diagnosis and differentials
- Next steps in management, including relevant investigations
Blood tests (two days ago, for review)
| Item | Value | Reference range |
|---|---|---|
| Sodium | 134 mmol/L | 135-145 mmol/L |
| Potassium | 5.6 mmol/L | 3.5-5.2 mmol/L |
| Urea | 18.4 mmol/L | 3.0-8.0 mmol/L |
| Creatinine | 214 umol/L | 60-110 umol/L |
| Baseline creatinine (last year's results) | 96 umol/L | 60-110 umol/L |
| Estimated glomerular filtration rate | 26 mL/min/1.73m2 | >90 mL/min/1.73m2 |
| Haemoglobin | 112 g/L | 130-180 g/L |