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A 70-year-old man comes to the physician because of urinary
hesitancy and frequency for 9 months. His temperature is 37.5 C (99.5
F). Examination shows a circumcised penis with no urethral discharge.
Testicular examination shows no abnormalities. Rectal examination
shows an enlarged rubbery prostate that is nontender to palpation.
Urinalysis shows many leukocytes and no erythrocytes. Gram's stain of
urine shows gram-negative rods. Which of the following is the most
likely cause of this patient's condition?

A
) Infection of the epididymis

B
) Infection of the prostate

C
) Infection of the urethra

D
) Neurogenic bladder

E
) Outflow obstruction of the bladder

A..prostate is not tender

isnt this classical for urethritis... gram neg rods... leukocytes.... nontender prostate

E) Outflow obstruction of the bladder -- non tender prostate -- BPH

no urethral dischage -- not urethritis

E.....

Gm -ve rods== E.coli (? normally present in some amount in Urine)

I would opt for E. BPH ... given teh symtoms and age....

urinalysis revealed many WBC but i i would go for E

EEEE

Hi guys,

I THINK IT'S C

Hesitancy and dysuria with rised temperature of 37.5 and the lab evidence of G-ve rods ( Most often E.Coli) are classical of Urethritis. There need not be any discharge to diagnose urethritis.

Regarding Outflow obstruction( BPH most likely), we do see hesitancy and frequency but not raised temperature and Urine C/S positive. There has to be an infection to get raised temperaqture and Urine C/s +ve. Option E doesn't say about infection..
Even if there is B>O>O, there has to be an infection to get these signs and labs

( If the option said E+ secondary infection , I would have gone for that)

Comments welcome

its chronic bacterial prostatites.a history of 9months duration + nontender enlarged proatate & evidence of infection+ the age of the pt.although no mention of experessed prostatic secretions..
what is the ans?