1- Potential Bladder Cancer Case 80 year old male presented with blood in urine, although there was no more visible blood in the urine today, a dip stick test showed that the urine sample was full of microscopic blood drops.
Diagnosis depends on the patients age sometimes:
Somebody of my age (20's) = they would want to exclude infection first
Somebody 50-60+ = You would want to rule out any chance of bladder cancer as it is easily treatable when caught early. The patient presented with 2 kidney stones but they were non obstructive, so the patient was referred for a cystoscopy, which involves passing a flexible camera down the end of the penis to view the bladder and see if there are any polyps on the bladder wall (done using local anaesthetic of course)
If anybody presented with blood in the urine, the first steps are to perform a blood test and an ultrasound of the bladder.
2-Lady With CRAZY High Blood Pressure 47 year old female had been taking blood pressure readings at home for years and failed to bring to the attention of her GP that her blood pressure was dangerously high.
We're talking 200/122!
She is being seen weekly until her BP in under control.3-Super Cool Fracture Male patient came in today about his problems with fully emptying his bladder and problems with the flow of his urine, BUT the interesting things about this patient was that he has a permanently fractured odontoid peg that doctors discovered after he electrocuted himself on his boat a few years ago, and have said it is too risky to operate on.
You can see in the photo an x-ray of a patient with their mouth open and you can see the odontoid process quite clearly. The process is a projection of the axis and allows us to rotate our head.
4-Necrotic Toes
80 year old female came in a few weeks ago after stubbing her toe, and the nurses thought it was a haematoma, so dressed her and sent her on her way. 2 weeks later the patient was back complaining that her toe wasn't healing, and on removal of the bandages it was very clear that the injured toe as well as the adjacent toe was necrotic.
The nurses took her blood glucose just as an off chance and it came back as 22.4!! The lady confessed she hadn't been to the doctors in 13 years and that she had a terrible diet of chocolate and sweets, obviously she has developed type 2 diabetes but not presented with any usual symptoms and so went however many years with uncontrolled diabetes! The wound she sustained from stubbing her toe then obviously did not heal properly due to the decreased blood flow to the feet from the diabetes. The lady had both the toes amputated at the local hospital later that day. One of the major complications of diabetes is the development of PAD - peripheral artery disease, which is the blockage or narrowing of arteries, in particular the ones in the legs.
I wont upload a photo of necrosis, it aint pleasant!
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