Which of the following is a type of skin cancer that is likely to metastasize if not treated early?

A. Flank pain is incorrect because flank pain is more commonly associated with an upper urinary tract infection such as pyelonephritis. It indicates kidney involvement rather than a lower urinary tract infection, which typically affects the bladder and urethra.

B. Urgent sensation to urinate is correct because urinary urgency is a hallmark symptom of a lower urinary tract infection, particularly cystitis. Inflammation of the bladder causes a frequent and urgent need to void even when little urine is present.

C. Fever is incorrect because fever is more commonly seen in upper urinary tract infections. While it can occasionally occur in lower UTIs, it is not a typical or defining symptom and suggests possible progression to a more serious infection.

D. Dysuria is correct because pain or burning during urination is a classic symptom of a lower urinary tract infection due to irritation and inflammation of the urethra and bladder lining.

E. Cloudy urine is correct because the presence of bacteria, white blood cells, and debris in the urine can cause it to appear cloudy. This is a common finding in lower urinary tract infections.

A. Generalized skin redness is incorrect because this is not a hallmark of vaso-occlusive crises. Skin redness may occur with infection or inflammation, but it does not specifically indicate sickle-cell complications.

B. Bleeding gums is incorrect because bleeding tendencies are not typical of sickle-cell anemia. Bleeding gums are more commonly associated with platelet disorders or vitamin C deficiency, not vaso-occlusion.

C. Joint pain is correct because a vaso-occlusive crisis occurs when sickle-shaped red blood cells obstruct small blood vessels, leading to reduced blood flow, ischemia, and tissue hypoxia. This results in severe pain, often in the joints, bones, chest, or abdomen, which is the hallmark symptom of a crisis. Other accompanying signs may include fever, swelling, and tenderness in affected areas. These pain episodes can be sudden, severe, and recurrent.

D. Bradycardia is incorrect because vaso-occlusive crises do not typically cause bradycardia. In fact, patients may develop tachycardia as a compensatory response to anemia or pain.