A 68 year old male presents to your clinic today. He complains of a cough for the last 2 months that will not go away. He also complains of frequent urination for the last 4 months. PHI only includes HTN diagnosed 5 years ago. He is does not know his family history since he was adopted. He has smoked ½ pack cigarettes for the last 40 year.


This case study presents a 68-year-old male patient who presents with a persistent cough for the past two months. The patient also reports frequent urination for the past four months. The patient’s medical history reveals a diagnosis of hypertension five years ago, and he has a long history of cigarette smoking. Additionally, the patient has limited knowledge of his family medical history due to being adopted. This essay will analyze the potential causes of the patient’s symptoms, focusing on respiratory and urological conditions that may explain his cough and frequent urination. Furthermore, it will discuss the importance of obtaining a thorough patient history, including family history, and the significance of conducting appropriate diagnostic tests to establish an accurate diagnosis and determine the most appropriate treatment plan.

Respiratory Causes:

Persistent cough for two months is a concerning symptom that warrants further investigation to determine its underlying cause. One possible respiratory condition that may be contributing to the patient’s cough is chronic obstructive pulmonary disease (COPD). COPD is a progressive lung disease characterized by airflow limitation, typically caused by long-term exposure to irritants, such as cigarette smoke (Vestbo et al., 2013). Given the patient’s history of smoking for 40 years, the development of COPD is plausible. Patients with COPD often experience a chronic cough, along with other symptoms such as shortness of breath and sputum production (Vestbo et al., 2013). Evaluating the patient’s lung function through spirometry can help confirm the diagnosis of COPD by assessing the forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) (Vestbo et al., 2013).

Another possible respiratory cause of the patient’s cough could be an underlying respiratory infection. A persistent cough is a common symptom of respiratory infections, such as pneumonia or bronchitis (Bjerre & Llor, 2018). Pneumonia is an infection that affects the lungs, typically caused by bacteria, viruses, or fungi (Bjerre & Llor, 2018). Bronchitis, on the other hand, is an inflammation of the bronchial tubes, often caused by a viral infection (Bjerre & Llor, 2018). Determining the etiology of the patient’s cough would require a detailed clinical examination, including auscultation of the lungs to identify any abnormal breath sounds, as well as appropriate diagnostic tests such as a chest X-ray or sputum culture (Bjerre & Llor, 2018).

Urological Causes:

Apart from the cough, the patient reports frequent urination for the past four months. This symptom may indicate a potential urological condition, such as benign prostatic hyperplasia (BPH). BPH is a non-cancerous enlargement of the prostate gland that commonly occurs in older men (Roehrborn, 2011). It can lead to urinary symptoms, including increased frequency of urination, urgency, and difficulty initiating or maintaining a steady stream of urine (Roehrborn, 2011). Given the patient’s age and symptoms, BPH should be considered in the differential diagnosis. Evaluating the size of the prostate gland through a digital rectal examination and performing a prostate-specific antigen (PSA) blood test can support the diagnosis of BPH (Roehrborn, 2011).

Another urological condition that may explain the patient’s frequent urination is urinary tract infection (UTI). UTIs occur when bacteria enter the urinary tract and cause infection (Stamm & Norrby, 2001). Common symptoms of UTIs include increased frequency of urination, urgency, pain or burning with urination, and cloudy or foul-smelling urine (Stamm & Norrby, 2001). Collecting a urine sample for urinalysis and urine culture can help confirm the presence of a UTI and identify the specific bacteria causing the infection (Stamm & Norrby, 2001).


In conclusion, the 68-year-old male patient presenting with a persistent cough and frequent urination could have a range of potential respiratory and urological conditions that might explain his symptoms. Respiratory causes, such as COPD or respiratory infections, should be considered in the differential diagnosis for the cough. Urological causes, including BPH or UTIs, should be explored for the frequent urination. Obtaining a thorough patient history, including family history, is crucial to identify any underlying genetic predispositions or risk factors. Conducting appropriate diagnostic tests, such as lung function tests, chest X-rays, digital rectal examinations, and urine analysis, can help establish an accurate diagnosis and guide the treatment plan. Further examination and investigations are required to provide an accurate diagnosis and appropriate management for the patient’s symptoms.

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