| Course | PA 524 Comprehensive Clinical Module Nephrology & Genitourinary |
|---|---|
| Week | 7 |
| Paper type | Urinary obstruction brief |
| Length | About 740 words, 5 pages |
| Format | APA 7 student paper |
| School | Chamberlain University |
| Program | Master of Physician Assistant Studies (MPAS) |
| Updated | October 2026 |
Free sample paper for PA 524 Week 7
Urinary Obstruction Brief: Retention Below the Bladder in G.H., a Bladder Scanner Reading of 820 mL Confirmed by 950 mL From the Catheter, Both Kidneys Dilated on Ultrasound and a Creatinine of 2.1
Student Name
Chamberlain University
PA 524: Comprehensive Clinical Module Nephrology & Genitourinary
Instructor Name
Month Day, Year
Urinary Obstruction Brief: Retention Below the Bladder in G.H., a Bladder Scanner Reading of 820 mL Confirmed by 950 mL From the Catheter, Both Kidneys Dilated on Ultrasound and a Creatinine of 2.1
The Level
The obstruction is below the bladder, at the bladder outlet, and it involves both kidneys because it is downstream of both ureters.
The Setting
This is the clinic visit introduced in the urinalysis week. G.H. had a week of dribbling and a weak stream, then two days of lower abdominal fullness. Ten days earlier an urgent care clinic had prescribed oxybutynin for urgency, and G.H. had also taken a cold medicine containing pseudoephedrine. G.H. has a known enlarged prostate and takes tamsulosin. The chemistry panel that day put creatinine at 2.1 mg/dL, about half again above the usual value of G.H.
One Kidney or Two
Obstruction above the bladder, such as a stone in one ureter, usually dilates one kidney and in a person with two working kidneys leaves creatinine near normal. A rise in creatinine with both kidneys affected points either to obstruction at or below the bladder or to obstruction of a single functioning kidney. G.H. has two kidneys of normal size, and both are dilated, which places the block below the point where the two ureters meet the bladder.
Volumes With Their Method
Table 1
Volumes and the Instrument Behind Each
| Measurement | Method | Result |
|---|---|---|
| Post-void residual | Portable bladder scanner, three readings, highest recorded | 820 mL |
| Drained volume | Straight catheter, drained over 10 minutes | 950 mL |
| Prostate volume | Transabdominal ultrasound, ellipsoid formula | About 68 mL |
Note. Note. The scanner underestimated the drained volume by about 130 mL, which is common at large volumes.
The drained volume is the reference, because the scanner estimates volume from an assumed bladder shape and can be thrown off by large volumes, body habitus or nearby fluid. The scanner was used to decide whether to catheterize; the catheter measured the result.
What the Pictures Showed
Renal ultrasound, done the same afternoon after the bladder had been drained: moderate dilation of the collecting systems on both sides, no stones, normal cortical thickness of 14 mm on the right and 13 mm on the left, and both kidneys 10.5 cm long. Bladder wall thickened and trabeculated, consistent with long-standing outlet obstruction. Preserved cortical thickness suggests the kidneys have room to recover.
Why Now
The prostate has been enlarged for years, but the retention came on after two medicines that each weaken bladder emptying: oxybutynin, an anticholinergic that relaxes the bladder muscle, and pseudoephedrine, which tightens the bladder neck and prostate. The urology guideline lists acute retention among the complications of an enlarged prostate and notes that patients with it often need procedural treatment if a trial without a catheter fails (Sandhu et al., 2024). Both medicines were stopped; the 2023 Beers criteria list strong anticholinergics among drugs older men with prostate symptoms should not be given (2023 American Geriatrics Society Beers Criteria Update Expert Panel, 2023).
Back Upstream
An indwelling catheter was placed. G.H. is being watched for a brisk outflow of urine after relief, which can cause volume depletion and electrolyte loss; urine output was measured hourly for the first 12 hours and electrolytes checked twice. Creatinine will be repeated in 48 hours. If it falls toward 1.4, the injury was largely from obstruction; if it stays high, part of the damage may be lasting. Repeat ultrasound in six weeks will show whether the dilation has resolved. Urology was asked to see G.H. within two weeks for a trial without the catheter and a discussion of a prostate procedure.
What G.H. Was Told
G.H. was told that the bladder had not been emptying, that the back pressure had reached both kidneys, and that the catheter would let the kidneys recover. The two medicines that likely tipped the balance were named, and G.H. was asked to avoid cold remedies containing decongestants and to show any new prescription to the clinic first. G.H. went home with a leg bag, instructions for catheter care and a number to call for fever, blood clots or no drainage.
References
2023 American Geriatrics Society Beers Criteria Update Expert Panel. (2023). American Geriatrics Society 2023 updated AGS Beers Criteria for potentially inappropriate medication use in older adults. Journal of the American Geriatrics Society, 71(7), 2052-2081. https://doi.org/10.1111/jgs.18372
Sandhu, J. S., Bixler, B. R., Dahm, P., Goueli, R., Kirkby, E., Stoffel, J. T., & Wilt, T. J. (2024). Management of lower urinary tract symptoms attributed to benign prostatic hyperplasia (BPH): AUA guideline amendment 2023. The Journal of Urology, 211(1), 11-19. https://doi.org/10.1097/JU.0000000000003698
Reading the PA 524 Week 7 instructions
The seventh week asks for a brief on urinary obstruction. State the level early, above or below the bladder, and keep that structure throughout. Explain whether one kidney or both are affected and what that implies about the level. Report every volume with the method that produced it, for example a bladder scanner estimate versus a drained catheter volume, and say which you rely on. Describe what imaging showed about the collecting systems, the kidney tissue and the bladder. Explain why the obstruction occurred now, including any medicines that may have contributed. Then return upstream: what happens to the kidneys after relief, what is monitored and when, and what would show lasting damage. Close with what the patient was told. Cite a guideline for the condition causing the obstruction.
How the PA 524 Week 7 example is put together
The brief opens with a one-line level, the bladder outlet, involving both kidneys. The setting describes dribbling, fullness, a known enlarged prostate on tamsulosin, new oxybutynin and a decongestant cold medicine, and a creatinine near half again above baseline. A section explains why bilateral dilation and a rising creatinine place the block below the ureters. Table 1 lists the scanner residual, drained volume and prostate volume with methods, and explains why the drained volume is the reference. Ultrasound findings include moderate bilateral dilation, preserved cortex and a trabeculated bladder. A cause section cites the AUA guideline and the 2023 Beers criteria. The upstream section covers post-obstructive diuresis, a 48-hour creatinine, a six-week scan and urology follow-up, and a final section records the patient's instructions.
Reading the PA 524 Week 7 grading rubric
The rubric favors a brief that states its level at the start and organizes every finding around it. Failing to commit to a level, or contradicting it later, loses the most. Faculty then check volumes: each must carry its method, and treating a scanner estimate as exact without comment is marked down. Credit goes to explaining what bilateral versus unilateral findings imply. Imaging is graded on description of the collecting systems, kidney tissue and bladder, not just a copied report. A section explaining why the obstruction happened now, including drug effects, earns significant marks. The return upstream must name what is watched after relief and when. A guideline for the underlying condition should be cited, along with any drug-avoidance source.
Common PA 524 Week 7 mistakes, and how to avoid them
The common slip in this brief is describing the findings without committing to where the blockage sits. Give us your case findings, volumes and imaging, and the brief written for you would state the level first, explain what one or two affected kidneys mean and report each volume with its method. Imaging is described in terms of the collecting systems, kidney tissue and bladder. A section explains why the obstruction happened when it did, including any medicines in your case. The monitoring after relief is set out with timing. If your case is a ureteral stone rather than an outlet problem, the same structure is used with the level above the bladder. Check each number against your own case before using the model's layout.
Get a PA-524 Week 7 example written to your instructions
Send the case and whatever imaging description your section provides, and a custom example built on it returns inside 24 to 48 hours, the first one free. Where the assignment wants a specific anatomical level argued rather than left open, say which, and the brief commits to that one from its first line.
More PA 524 papers and MPAS samples
- PA 524 Week 1: Filtration Stand-In Discussion Post
- PA 524 Week 2: eGFR Estimate Write-Up
- PA 524 Week 3: Urinalysis Interpretation
- PA 524 Week 4: Prerenal Versus Intrinsic Brief
- PA 524 Week 5: Volume and Sodium Case
- PA 524 Week 6: Acid-Base Disorder Set
- PA 524 Week 8: Renal Dosing Adjustment Table
- PA 522 Week 7: Adrenal Incidentaloma Workup
- PA 520 Week 7: 6-Minute Walk Test Report
- PA 518 Week 7: Stroke Risk Scoring Memo
- PA 516 Week 7: Sinus Imaging Rationale
PA 524 Week 7 questions, answered
Our case is a stone rather than retention. Does the brief change?
The shape holds and the anatomy moves. A stone sits above the bladder, so the brief argues one side rather than both, and the imaging paragraph carries more weight because the location and the size are what the rest of the reasoning hangs on. The residual volume section shrinks to a line. Send the case and the example is built to whichever version your section set.
Can the example include an imaging report?
It can include a constructed one, written in the form a radiology report takes and consistent with every other value in the case. Nothing is copied from a real study. If your assignment supplies the report, the example reads that one instead and spends its space on what the findings mean for the level rather than on restating them.
The assignment asks what to do about the obstruction. How far does the example go?
It goes as far as naming the category of action the findings point toward and no further, which is where these pages stop by design. Choosing the intervention is your course's territory and stays there. What the example does instead is demonstrate the layout, the citation pattern your section requires, and the point at which a written answer stops.
Where can I find a free PA 524 Week 7 sample paper?
This page carries the full PA 524 Week 7 obstruction brief, retention below the bladder with an 820 mL scanner estimate confirmed by 950 mL drained.
Why does the PA 524 Week 7 brief rely on the catheter volume?
A bladder scanner estimates volume from an assumed shape and tends to underestimate large volumes, so the measured drained volume is the reference.