Differential Diagnosis for 73 y/o Male with Urinary Frequency and Increased Thirst
Single Most Likely Diagnosis
- Benign Prostatic Hyperplasia (BPH): Given the patient's age and symptoms of urinary frequency, BPH is a common condition in older males that can cause these symptoms due to prostate enlargement leading to urinary obstruction.
Other Likely Diagnoses
- Overactive Bladder: This condition can cause urinary frequency and urgency, and while it can occur at any age, it becomes more common with increasing age.
- Urinary Tract Infection (UTI): Although more common in women, UTIs can occur in men, especially at older ages, and can cause symptoms of urinary frequency and increased thirst.
- Medication Side Effects: Certain medications, such as diuretics, can cause increased urine production leading to frequency and thirst.
Do Not Miss Diagnoses
- Diabetes Insipidus: Although the patient's last A1c was normal, diabetes insipidus (central or nephrogenic) can cause significant polyuria and polydipsia and must be considered.
- Kidney Disease: Chronic kidney disease can lead to polyuria and increased thirst, and given the patient's age, it's a condition that should not be overlooked.
- Hypercalcemia: Can cause polyuria due to its effect on the kidneys' ability to concentrate urine, and it's crucial to identify as it can have serious implications.
Rare Diagnoses
- Pituitary Tumors: Although rare, tumors affecting the pituitary gland can lead to central diabetes insipidus, causing the patient's symptoms.
- Nephrogenic Diabetes Insipidus due to Lithium Use: If the patient is on lithium, this could be a rare cause of his symptoms, as lithium can affect the kidneys' ability to respond to ADH.
- Sjögren's Syndrome: An autoimmune disorder that can affect exocrine glands, including those in the kidneys, potentially leading to symptoms of polyuria and polydipsia.