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  Item Reference: KCLCAL-1889-1890-782

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136 MEDICAL DEPARTMENT IV -Case in burger for Commentary man aged about 40 gives the following history -Has had for many years considerable difficulty in passing water latterly the stream has got so small that at times the urine can only be voided by drops and then after considerable straining His sleep is constantly disturbed by his having to get up to pass small quantities and in the day-time his shirt is always wet with urine Whilst straining violently to pass water the patient suddenly felt distension of the perinseum accompanied at first by feeling of relief from the more urgent symptoms but quickly followed by burning and tingling sensation culminating in severe throbbing pain the perinaaum and scrotum became rapidly swollen and tense He is seen by surgeon who finds it necessary to immediately perform an operation From what disease was this patient suffering and to what was the sudden accession of symptoms due Explain the direction the perineal swelling took describe the operation that was necessary and give the subsequent treatment of the case -obstetric iKetttam State what you know of the causes pathology and pre- vention of puerperal septicaemia treatment and symptoms not required What are the most common traumatic lesions following labour What are their effects on the subsequent health of the patient How are they to be dealt with State what you know of the removal of the uterine appendages as an operation What are the cases for which it has been recommended And give an estimate of the value and justifiability of the operation
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