tailieunhanh - Thực hành xử lý sản khoa - Trường hợp 8

Tham khảo tài liệu 'thực hành xử lý sản khoa - trường hợp 8', y tế - sức khoẻ, y dược phục vụ nhu cầu học tập, nghiên cứu và làm việc hiệu quả | CASE 33 A 29-ycar-old woman complains of a 2-day history of dysuria urgency and urinary frequency. She denies the use of medications and has no significant past medical history. On examination her BP is 100 70 HR 90 min and temperature 98 E The thyroid is normal on palpation. The heart and lung examinations are normal. She does not have back tenderness. The abdomen is nontender and without masses. The pelvic examination reveals normal female genitalia. There is no adnexal tenderness or masses. What is the most likely diagnosis What is the next step in the diagnosis What is the most likely etiology of the condition 274 CASE EILES OBSTETRICS AND GYNECOLOGY ANSWERS TO CASE 33 Urinary Tract Infection Cystitis StiHiiHiirv A 29-ycar-old woman complains of a 2-day history of dysuria urgency and urinary frequency. Her temperature is 98 E She docs not have back tenderness. The abdomen is nontender and without masses. The pelvic examination is normal Most likely diagnosis Simple cystitis bladder infection . Next step in the diagnosis Urinalysis and or urine culture. Most likely etiology of the condition Escherichia coll E. coll . Analysis Objectives 1. Know the symptoms of a urinary tract infection cystitis . 2. Know that the most common bacteria causing cystitis is Escherichia C H. 3. Be familiar with some of the antibiotic therapies for cystitis. Considerations This 29-year-old woman has a 2-day history of urinary urgency frequency and dysuria all which arc very typical symptoms of a urinary tract infection. Because she docs not have fever or flank tenderness she most likely has a bladder infection or cystitis. Other symptoms of cystitis include hesitancy or hematuria hemorrhagic cystitis . Urinalysis and or urine culture and sensitivity would be the appropriate test to confirm the diagnosis. Since E. coli is the most common etiologic agent the antibiotic treatment should be aimed at this organism. Sulfa agents cephalosporins quinolones or nitrofurantoin are all .