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What would be the diagnosis and 3 differential diagnoses? 

 

Ronaldo comes in today with his daughter. She is concerned that her father has started acting strange, asking questions about things he should already know, losing things, seeming more irritated. He says that he has had some constipation for the last few weeks. He also notes that during the last few weeks he has been having a hard time starting a urine stream. No other symptoms or concerns and no fevers.

 

PE: 99.8, HR 97, RR 16, BP 98/66, Wt. 158lbs
Neurologically: A&O x 3, does seem irritated with questioning
Lungs: CTA
Heart: RRR with no murmur
Abdomen: Soft, tenderness to suprapubic area, hypoactive bowl sounds, no CVA tenderness
GU: No penile drainage or rash, no erythema
Skin: No rash, warm, moist, intact

 

U/A: Specific Gravity: 1.010
pH: 6
Leukocytes: Moderate
Blood: Negative
Nitrite: Negative
Ketones: Negative
Bilirubin: Negative
Urobilinogen: Normal
Protein: Negative
Glucose: Negative

 

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