Urinary Tract Infections (UTI) -- Student (2)

Patient case 1 kc a 25 yo f presents to the office

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Patient Case 1 KC, a 25 yo F, presents to the office with a 3 day history of frequency, dysuria, and one day of fever & chills. She also complains of R sided flank pain. She has no significant past medical history. She states she is sexually active. Physical exam is significant for R CVA tenderness.
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Patient Case 1 Urinalysis (mid-stream, clean catch) Many bacteria 16 WBCs/mm 3 2 RBC/mm 3 Nitrite positive LE positive Urine specimen sent for culture Pregnancy test: negative
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Patient Case 1 What risk factor(s) or predispositions does KC have for an UTI? What signs and symptoms does KC have that are consistent with an urinary tract infection?
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Patient Case 1 Does this patient have cystitis or pyelonephritis? What UA findings are support the diagnosis of a UTI?
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Patient Case 1 What organism is most likely to be causing this patient’s UTI? Does this patient have complicated or uncomplicated UTI?
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Patient Case 2 KR, a 73 yo M, who presents to the ER with altered mental status. His PMH includes HTN, HL, heart failure, and depression. He presents with a Foley catheter in place. The patient does not have a fever. It is difficult to discern if the patient has dysuria, frequency, or urgency.
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Patient Case 2 Urinalysis (catheterized) Many bacteria 65 WBCs/mm 3 5 RBC/mm 3 Nitrite negative 2+ LE
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Patient Case 2 What symptoms are consistent with a UTI? What are the patient’s risk factors for UTI? Does this patient have complicated or uncomplicated UTI?
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Patient Case 3 LP, a 32 yo pregnant F, in a routine visit has a UA showing 5 WBC, 0 RBC, (+) nitrite, (-) LE, and many bacteria. Her urine culture shows >100,000 CFU/mL of bacteria in her urine. She denies fever, dysuria, urgency. She states she has frequency, but no different than usual.
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Patient Case 3 Does this patient have cystitis, pyelonephritis, or asymptomatic bacteruria?
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