Reference no: EM133995275

Question

RA is a 68 year-old male who presents to your clinic today with the chief complaint of difficulty urinating. He tells you that he feels the urge to urinate every one to two hours, and that his urine flow seems like it's "more of a dribble," even though he pushes hard to try and empty his bladder. He denies fever, changes in bowel patterns. RA appears very uncomfortable and said these issues are impacting his ability to do work around the house and get a good night sleep. Social history: Negative for cigarette smoking and alcohol use. He has been married for 40 years, denies any new sexual partners. He does not exercise regularly. He drinks 2-3 cups of coffee each morning and 2-3 beers several nights of the week. Denies family history of any cancer. Allergies: NKDA Vitals: • Vitals: BP 130/84 mmHg, HR 78 bpm, and RR 14 rpm • Hgt: 5'11", Wgt: 230 lbs, BMI 32.1 PMH: • HTN • HLD Physical Exam • GU: enlarged, non-tender prostate on DRE Last labs: Na 134 mEq/L K 4.1 mEq/L Cl 102 mEq/L CO2 24 mEq/L SCr 1.0 g/dL BUN 13 mg/dL Glucose 108 mg/dL PSA 7.2 ng/mL Urinalysis: