TSR Med Students' Society Part IV

How common are dual CCTs? Are they just one of those things that are theoretically possible but essentially unheard of in reality?

Depends what you mean. In related specialties like ICM and anaesthesia, still quite common, though ICM are trying to break away, but I'm not convinced how viable that is going to be. Most physicians will dual CCT in General Medicine and a specialty. It is, however, much less common to see people with a dual CCT in two completely unrelated specialties, or if they do have both, they tend to only practice one.

Yeah I was curious about the ACCS specialities in particular. That's interesting to know, thank you.

This is the history of a patient and I have to identify likely causes for underling symptoms.

57 year old sales representative who is usually fit and well.
He drinks occasional alcohol and smokes 20 cigarettes a day, which he has done since the age of 16.
His symptoms
a burning sensation when passing urine
lower abdominal pain.
A week later left-sided back ache which became worse and started to move from his back to his groin.
short-lived episodes of ‘chills’ and uncontrollable shaking.
blood in his urinary stream on several occasions - painless.

symptoms:
The haematuria
The pattern of pain ( nature and site)
The cloudy urine
The ‘shakes’ or rigors that he had


I was thinking it might be a UTI, but I'm not particularly sure. Pain is his back indicated kidneys so perhaps a cancer that has spread down the UT?

This is the history of a patient and I have to identify likely causes for underling symptoms.

57 year old sales representative who is usually fit and well.
He drinks occasional alcohol and smokes 20 cigarettes a day, which he has done since the age of 16.
His symptoms
a burning sensation when passing urine
lower abdominal pain.
A week later left-sided back ache which became worse and started to move from his back to his groin.
short-lived episodes of ‘chills’ and uncontrollable shaking.
blood in his urinary stream on several occasions - painless.

symptoms:
The haematuria
The pattern of pain ( nature and site)
The cloudy urine
The ‘shakes’ or rigors that he had


I was thinking it might be a UTI, but I'm not particularly sure. Pain is his back indicated kidneys so perhaps a cancer that has spread down the UT?

This is the history of a patient and I have to identify likely causes for underling symptoms.

57 year old sales representative who is usually fit and well.
He drinks occasional alcohol and smokes 20 cigarettes a day, which he has done since the age of 16.
His symptoms
a burning sensation when passing urine
lower abdominal pain.
A week later left-sided back ache which became worse and started to move from his back to his groin.
short-lived episodes of ‘chills’ and uncontrollable shaking.
blood in his urinary stream on several occasions - painless.

symptoms:
The haematuria
The pattern of pain ( nature and site)
The cloudy urine
The ‘shakes’ or rigors that he had


I was thinking it might be a UTI, but I'm not particularly sure. Pain is his back indicated kidneys so perhaps a cancer that has spread down the UT?

Or a UTI that has ascended the ureters leading to pyelonephritis?

Easiest way of remembering causes of haematuria: TITS.
Trauma, infection, tumour, stones.

The pattern of pain sounds like renal colic.

When you have something urinary, think about the whole tract, and what can go wrong at each level and how it affects the bit above/below it.

sounds like pyelonephritis.
unusual for a man with a normal urinary tract to get UTIs so you would think about his prostate gland.

so it's more common in women?

so it's more common in women?

Wiping in the wrong direction (can't just shake it after a pee like guys can) can easily introduce bowel bugs to the urinary tract, and shorter urethra means they get into the bladder etc more easily.

Yes. Without sounding too grim, in women the urethra opens into an area that is much more likely to have bacteria present (from bowel) than in men. Also the urethra is shorter in women than in men, so an infection can ascend to the bladder more easily.

This is the history of a patient and I have to identify likely causes for underling symptoms.

57 year old sales representative who is usually fit and well.
He drinks occasional alcohol and smokes 20 cigarettes a day, which he has done since the age of 16.
His symptoms
a burning sensation when passing urine
lower abdominal pain.
A week later left-sided back ache which became worse and started to move from his back to his groin.
short-lived episodes of ‘chills’ and uncontrollable shaking.
blood in his urinary stream on several occasions - painless.

symptoms:
The haematuria
The pattern of pain ( nature and site)
The cloudy urine
The ‘shakes’ or rigors that he had


I was thinking it might be a UTI, but I'm not particularly sure. Pain is his back indicated kidneys so perhaps a cancer that has spread down the UT?

Ah that makes sense. I'm not too sure of the details of female urination tbh but that cleared things up.

Pretty sure it's the exact same as with the male urinary system with the exception of a bit of anatomy. Urethral meatus a bit above the vagina, and the urethra itself is shorter. Added factor of all 3 orifices being pretty close to each other, and they have to pay a bit more attention to urinary hygiene than we do.

The fact that I can pee standing up and just shake it off at the end is easily the best thing about being male.

Seriously? So not the fact that you don't have periods or have to go through labour?