What additional data are important to factor into this picture? Do you do vaginal ex and why? Should you do urine culture and sensitivity? What are things in the medical history that may provide clues to the possible cause of dysuria? What are the possible differential diagnoses for this patient and how do you rule them in or out
A 22 year old black woman present with complaints of burning and frequency of urination for the past 2 to 3 days. It is getting worse. She feels she has to void, rushes to the bathroom and then is only able to void a small amount. it is painful. There is no sign of blood in the urine. She denies fever, chills, diarrhea, nausea, vomiting or vaginal discharge.
" I have to rush to the bathroom, and it hurts when I urinate".
Physical Ex:
Essentially unremarkable. Negative suprapubic tenderness: negative costovertebral angle tenderness. Negative abdominal pain and benign abdominal exam. Negative back pain. Afebrile. Vital signs normal. No complaints of vaginal discharge. Uranalysis shows+ WBCs, trace RBCs.
- What additional data are important to factor into this picture? Do you do vaginal ex and why? Should you do urine culture and sensitivity?
- What are things in the medical history that may provide clues to the possible cause of dysuria?
- What are the possible differential diagnoses for this patient and how do you rule them in or out?
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