![]() Testes are descended bilaterally and are normal topalpation. GENITALIA: Normal external male genitalia. Bowel soundsare normal.ĮXTREMITIES: No peripheral edema or varicosities. There is no guarding or rebound tenderness. ABDOMEN: There is slight left flank tenderness to deep palpation. LUNGS: Clear to percussion and auscultation. HEENT: Pupils are equal, round and reactive to light and accommodation. GENERAL: Well-developed, well-nourished white male in no acute distress. ![]() VITAL SIGNS: Pulse is 72 and regular, respirations 18 and regular, blood pressure 122/78. Denies emesis, melena, constipation, diarrhea or rectal bleeding. Gastrointestinal: He has occasional indigestion. Cardiorespiratory: Denies shortness of breath, dyspnea on exertion, chest pain, cough or hemoptysis. Musculoskeletal: No muscle or joint pain. REVIEW OF SYSTEMS: Neurologic: Denies vertigo, syncope, convulsions or headaches. Smokes one pack of cigarettes per day over the last 10 years.įAMILY HISTORY: Father died of cancer, type unknown. Diovan 80 mg with hydrochlorothiazide 12.5 mg daily.ĪLLERGIES: There are no known drug allergies. PAST MEDICAL HISTORY: He had surgery on his right knee two years ago.ġ. The patient is admitted at this time for complete urologic evaluation. He had a right kidney which was malrotated but was otherwise normal. It was suggested that a renal MRI be done for further delineation of this problem. ![]() This showed what appeared to be an infarction of an area of the lower pole of the left kidney. The patient subsequently had a CT renal scan with contrast. Urine cytology was negative for malignant cells. There was no evidence of renal or ureteral calculi or hydronephrosis. Intravenous pyelogram was done which demonstrated a low-lying malrotated right kidney. When seen in our office, the patient continued to have mild left flank pain and no difficultly voiding. The patient had a CT stone profile which showed no evidence of renal calculi. HISTORY OF PRESENT ILLNESS: This is a (XX)-year-old white male who went to the emergency room with sudden onset of severe left flank and left lower quadrant abdominal pain associated with gross hematuria.
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