Presenting Complaint - Flank Pain
Mr JM presents to you in A&E with a four hour history of excruciating left flank pain. He introduces himself as a man of wealth and taste. It was first brought on in his bathroom (recently painted black) and is colicky in nature. He has experienced two episodes of vomiting associated with nausea. A slight fever is noted, otherwise examination is unremarkable. A urine dip showed the presence of Brown Sugar.
An X-ray is initially requested but confusingly returns negative, as does a renal ultrasound. The patient grows irritable, insisting that all he wants is some satisfaction by getting rid of his pain. For the sixth month in a row, you are stumped until a passing Brazilian model suggests a renal biopsy, where you see the film below:What's the diagnosis?
That's right, kidney stones.
This common affliction affects more men than women and incidence is reducing as Hip Hop grows in popularity. The presence of any of the Stones on biopsy is pathognomonic for this condition. Symptoms include sufferers not being able to get any satisfaction, despite them trying and trying and trying and trying. It should be noted that the finding of Mick Jagger or Charlie Watts in young girls is not uncommon and is associated with a poor prognosis.Management consists of smoking cessation, listening to the Beatles and prescribing shitloads of steroids - they're awesome. In uncomplicated cases, stones have been known to easily pass through the urinary tract, eased by their 'rolling' nature.
Medical Student Teaching #1
Medical Student Teaching #3
Originally published in Medical Student Newspaper.
Labels: Medical Student Teaching, medical students
Post a Comment
Diversity Writer of the Year
Runner-up Columnist of the Year
Nominated Features Writer of the Year
It's the Pirates
Yam Boy
Video Wallah
Shiva Soundsystem
Within / Without
Saheli Datta
Random Acts of Reality
NHS Blog Doc
The Oracle
Turbanhead
HERStory
Ethno Techno
2. Rohinplasty (series)
3. Medical student teaching (series)
4. What your stetho says about you
5. Revision: IT BRINGS DEATH
6. Things you kids won't see (series)
7. Tsunami Politics
8. Churchill: Let the fakir die
9. If it looks like a quack...
10. Ten million missing girls
Crys-tal poppin'
Snowdon Returns to India
The Buddha of sub-Bara
The Party that Launched a Thousand Ships (well, 3 ...
Things you probably won't be showing your kids: Pa...
Sanjay Gupta Rip Off Merchant
BANSAI
Star Dust
A lovely faith school
August 2005
September 2005
October 2005
November 2005
December 2005
January 2006
February 2006
March 2006
April 2006
May 2006
June 2006
November 2006
December 2006
February 2007
May 2007
June 2007
July 2007
August 2007
October 2007
November 2007
February 2008
March 2008
April 2008
May 2008
July 2008
December 2008
-->