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CLINICAL               6        PATIENT PRESENTATIONS RELATED TO THE
          PRESENTATION
                                          GENITOURINARY/RENAL SYSTEM AND BREASTS




             Patient presentations span all relevant age                              The Guide to clinical presentations in this category may
             categories, special populations, and varied                              include, but is not limited to, the following ways in which
             clinical settings.                                                       patients present for osteopathic medical care:


                                                                                      bleeding, abnormal genital (vaginal or uterine), such as menorrhagia,
                                                                                      menometrorrhagia, non-gynecologic causes (eg, in nonpregnant or anovulatory
                                                                                      female) • breast conditions – masses, benign or malignant, including fibrocystic
             6.1    ANURIA, OLIGURIA, POLYURIA, AND EDEMA
                                                                                      disease; nipple discharge, including galactorrhea; gynecomastia and mastitis;
             6.2    ENURESIS/INCONTINENCE, PROLAPSE AND PELVIC
                 RELAXATION                                                           mastalgia • breast procedures – mastectomy (modified, radical), lumpectomy;
                                                                                      augmentation or reduction;  stereotactic biopsy • estrogen deficiency • genital
             6.3    URINARY FREQUENCY/HESITANCY, DYSURIA, URINARY
                 RETENTION                                                            lesions, inflammatory or neoplastic causes, local or systemic, male or female –
             6.4    HEMATURIA AND DISCOLORED URINE                                    excoriations and infestations; ulcers/ and erosions (painful or painless); vesicles,
                                                                                      plaques and papules; vulvovaginitis • gynecologic and pelvic masses and lesions
             6.5    AMENORRHEA AND VAGINAL BLEEDING
                                                                                      – cyst or tumor of uterus, ovaries, or fallopian tube(s), benign, malignant, or
             6.6    URETHRAL DISCHARGE
                                                                                      metastatic; pelvic adhesions • kidney disease, acute or chronic including
             6.7    PELVIC PAIN                                                       nephrolithiasis or calculus disease (kidney stones); diabetic nephropathy; end-stage
             6.8    VULVAR AND VAGINAL DISCHARGE, LESIONS, AND PAIN                   renal disease; hemolytic uremic syndrome; nephrotic syndrome; renal masses,
                                                                                      solid or cystic • kidney injury, acute • menopause • menstrual abnormalities,
             6.9    PENILE, SCROTAL, AND TESTICULAR LESIONS, MASSES,
                 PAIN, AND BLEEDING                                                   including dysmenorrhea, ovulation pain; ovarian torsion; premenstrual syndrome;

             6.10  PELVIC, PROSTATE, AND RENAL MASSES                                 primary and secondary amenorrhea; toxic shock syndrome • pelvic infection and
                                                                                      inflammation, female (eg, endometriosis, pelvic inflammatory disease) • pelvic
             6.11  BREAST MASSES, DISCHARGE, AND PAIN
                                                                                      pain, acute or chronic • pelvic relaxation and pelvic organ prolapse – uterus,
             6.12  PHYSICAL EXAM FINDINGS RELATED TO THE                              vagina, bladder (cystocele), bowel/rectum (enterocele, rectocele) • prostate
                 GENITOURINARY/RENAL SYSTEM AND BREASTS
                                                                                      conditions, including prostatitis; benign prostatic hypertrophy; masses, benign,
             6.13  LABORATORY TEST FINDINGS AND DIAGNOSTIC IMAGING
                 RELATED TO THE GENITOURINARY/RENAL SYSTEM AND                        malignant, or metastatic • sexually transmitted diseases and infections, males
                 BREASTS                                                              and female • testicular and scrotal conditions, including orchitis, epididymitis;
                                                                                      testicular torsion; scrotal masses, painful or painless, benign or malignant (eg,
                                                                                      hydrocele, varicocele, tumor) • tubular necrosis, acute • urinary tract infections
                                                                                      and conditions – upper vs lower, cystitis, urethritis, pyelonephritis,   


        COMLEX-USA MASTER BLUEPRINT                                                                DIMENSION 2     CLINICAL PRESENTATION 6     PAGE 51
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