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"I have pain while passing urine" Dx: Acute Urinary Infection,…
"I have pain while passing urine"
Dx: Acute Urinary Infection
symptoms
Dysuria for 3 days
Oliguria
Nocturia
Had urgency and strangury
during urination
Cloudy urine
About patient
28 years old
prevalence age 16-35 y/o
woman
higher risk in woman due to anatomical feature: shorter urethra, shortens the distance that bacteria must travel to reach the bladder
History
recurrent UTI
higher risk to get another infection bcs the pathogens from the previous infection can stay dorman until the next infection
Diabetes Melitus
Social history:
sexually active
Having sex can make it easier for germs to get into a woman's urethra
colonization of the urethra
bacteria gain entry into bladder
Urine culture: E.coli
Presence of bacteria
bacterial colony irritates the urinary epithelium
bacteria release enzyme to turn nitrate to nitrite
3 more items...
stimulate urinary reflex
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married
works as waitress
heavy smoker
weak body immune system
General physical examination
Vital sign
Pulse rate: high
Urine analysis
There's albumin trace
hypoalbuminaemia
decrease blood oncotic pressure
fluid transudate outside the blood capillary
decrease blood volume
renal hypoperfussion
activated RAAS
release of ADH: vasopressin
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increase sodium and water reabsorbtion
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decrease venous return
heart try to compensate by increasing heart rate
Bood test
Total WBC: high
Leukocyte release Interleukin-1
Interleukine-1 stimulate the production of prostaglandine
Prostaglandin cross the blood brain barrier and signal the anterior hypothalamus
anterior hypothalamus cause elevation of thermoregulatory set-point
cause sympathetic activation
Resp rate: high
Neutrophils: high
Treatment
Cephalexin capsule
500mg/ 2 time daily for 10 days
antibiotic
contain a beta lactam and dihydrothiazide
inhibits bacterial cell wall synthesis
cell death
she was febrile
Temperature: high
PBL10 URS
Nur Zarifah Binti Mohd Zaki
2019481826