OSCE and LEARNING POINTS

 http://vinilabhavani.blogspot.com/2023/12/k-vinila-bhavani-case-of-63-yr-old-male.html 
OSCE QUESTIONS
1. The sensitivity of diagnosing BPH or prostatomegaly by ultrasound?
BPH appears in TRUS as an echogenic and non-mobile mass. TRUS is mainly used to assess prostate volume, which is crucial for therapeutic strategies. Prostate volume can be estimated by serial planimetry, orthogonal plane, rotational body (single plane, ellipsoid) and three-dimensional methods.
Staging sensitivities in studies using grey-scale TRUS varied between 30% and 50% with specificities between 77% and 96%. Three-dimensional TRUS aided in the assessment of extracapsular extension and seminal vesicle invasion.

2. How does hypothyroidism affect urine retention?  
In hypothyroidism there is loss of medullary hypertonicity impairing urinary concentration ability of kidneys . In hypothyroidism there is a reversible increase in vasopresssin sensitivity causing increased water reabsorbption 

3. What are the  causes of  external rotation of lower limbs ?
Unopposed pull on iliopsoas muscle which is attached to lesser trochanter or femoral retroversion 

4.How can u differentiate urinary retention from renal failure ? 
In renal failure urine production is decreased thus there is requirement of dialysis whereas in urinary retention urine output is seen on catheterization 

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