signs and symptoms of lower versus upper urinary tract infection.

Women’s Health Case Study Assignment 4

Women’s Health Case Study Assignment 4

You will complete the Aquifer case, Internal Medicine 14: 18-year-old female for pre-college physical, focusing on the “Revisit three months later” for this assignment.

After completing the Aquifer case, you will present the case and supporting evidence in a PowerPoint presentation with the following components:

Slide 1: Title, Student Name, Course, Date
Slide 2: Summary or synopsis of Judy Pham’s case
Slide 3: HPI
Slide 4: Medical History
Slide 5: Family History
Slide 6: Social History
Slide 7: ROS
Slide 8: Examination
Slide 9: Labs (In-house)
Slide 10: Primary Diagnosis and 3 Differential Diagnoses – ranked in priority
Primary Diagnosis should be supported by data in the patient’s history, exam, and lab results.

Slide 11: Management Plan: medication (dose, route, frequency), non-medication treatment, tests ordered, education, follow-up/referral.
Slide 12-16: An evaluation of 5 evidence-based articles applicable to Ms. Pham’s case: evaluate 1 article per slide.
Include title, author, and year of article
Brief summary/purpose of the study
How did the study support Ms. Pham’s case?
Course texts will not count as a scholarly source. If using data from websites you must go back to the literature source for the information; no secondary sources are allowed, e.g. Medscape, UptoDate, etc.

Slide 17: Reference List

Differentiate /distinguish signs and symptoms of lower versus upper urinary tract infection.

Recognize /recommend when to order diagnostic and laboratory tests in evaluation of dysuria, including urinalysis, wet prep, and KOH stain.

Describe current recommendations for cervical cancer screening.

Discuss safe sexual practices and efficacy of common methods of contraception.


Adolescent Interview – Safety


The leading causes of death in older adolescents are violent: suicide, injuries, and homicide. Bullying, family violence, sexual abuse, date rape and

school violence are all common. In many urban communities, up to one in four students report carrying a weapon to school. Family violence and

dating violence cross all economic and social boundaries.


For some teens, school violence and guns are the major risks, and in others, sports injuries and injuries from wheeled vehicles are more likely. It is

important to address use of a seat belt and bike helmets with every adolescent.

Even though you address the safety issues most prevalent in the patient’s community first, do not skip any part of the history based on assumptions

about the patient’s ethnic background or economic status.

Recommended Vaccinations for Adolescents and Teenagers Women’s Health Case Study Assignment 4


MMR is recommended in adults who have not been previously vaccinated as children. An exception to this recommendation is the

case of pregnant women. Pregnant women should not be vaccinated with MMR because of a risk of fetal transmission since it is a

live virus vaccine.

Hepatitis B Hepatitis B vaccination is effective in preventing hepatitis B virus infection and its sequelae of cirrhosis and hepatic carcinoma. The

series of three injections is recommended for adolescents if they did not receive them when younger.


The meningococcal vaccine is given to prevent meningococcal meningitis. It is commonly given once at age 11-12 years during the

routine preadolescent immunization visit with a booster dose at age 16 and is recommended for all previously unvaccinated

adolescents aged 11-18 years.



There are two different human papillomavirus vaccines available. They vary by the number of strains of HPV they protects against,

ranging from four to nine, and can prevent most cases of cervical cancer and genital warts. It is recommended for girls and women

9-26 years old.

The Advisory Committee on Immunization Practices (ACIP) recommends the use of the HPV vaccine in males 11 or 12 years of age.

ACIP also recommends vaccination in males ages 13 through 21 who have not been vaccinated previously or who have not

completed the three-dose series. ACIP states that males aged 22 through 26 years may be vaccinated, but does not recommend

routine vaccination in this age group.





The tetanus, diphtheria, acellular pertussis (Tdap) vaccine protects against tetanus, diphtheria and pertussis. It contains acellular

pertussis vaccine (ap), which is less reactogenic than the older whole-cell pertussis vaccine that caused high fever and neurologic

symptoms when given to older children and adults. Tdap, which was licensed in 2005, is the first vaccine for adolescents and adults

that protects against all three diseases.

Adolescents should receive a single dose of Tdap as a booster between the ages of 11 and 18, with the preferred timing between 11

Differentiate /distinguish signs and symptoms of lower versus upper urinary tract infection.


You may have a urinary tract infection (UTI) or an upper urinary tract infection (u/t). UTIs are caused by bacteria that live in your bladder, urethra and kidneys. They can cause pain, burning with urination and urgency to void. The main symptom of a UTI is blood in the urine.

Lower urinary tract infection (LUTI)

  • You may have a urinary tract infection if you have symptoms of:
  • Pain in the lower abdomen or pelvis
  • Fever, chills and sweats (chills)
  • Cloudy urine that appears to be bloody or cloudy after urination or ejaculation.

Urinary tract infection (UTI)

Urinary tract infection (UTI) is an infection of the urinary tract. UTIs are very common, but it can be difficult to tell if you have one. They may cause symptoms such as:

  • Fever
  • Pain or burning when urinating

Signs and symptoms of a UTI

Signs and symptoms of a UTI include:

  • Burning sensation when urinating
  • Blood in the urine
  • Fever, chills or headache (in severe cases)
  • Pain in the lower abdomen or pelvis, especially if accompanied by pain during sexual intercourse. If you have any of these signs and symptoms it’s important to see a doctor as soon as possible.

Upper urinary tract infection (u/t)

You may be wondering if a UTI is similar to a U/T infection. If so, what are the differences?

Well, it’s true that both infections can happen in the upper part of your urinary tract (the kidneys, ureters and bladder). But there are some key differences:

  • A UTI usually causes pain or burning when passing urine; this can lead to distention of your bladder or even an urgent need to pass urine. The presence of blood in your urine (hematuria) is also common with UTIs.
  • A U/T infection doesn’t cause any symptoms at all except maybe some back pain from coughing up mucus from an inflamed area around where we expect our urethra would be—but again these symptoms may not be present unless we have been infected for over 24 hours already!

Signs and symptoms of an u/t infection.

Upper urinary tract infections (UTIs) are more common in women than men, especially those who have had a hysterectomy or who have diabetes. Symptoms of an u/t infection include:

  • Fever
  • Back pain
  • Urinary frequency and urgency, with the sensation of needing to urinate immediately. This can be accompanied by burning when you pass urine or an urgent need to go to the bathroom that cannot be delayed any longer. You may also feel bloated and nauseous as you pass urine even if there is no actual blood in your urine; this is because of the presence of bacteria in your lower urinary tract that travel up into your kidneys during infection. People often describe this feeling as feeling like they have gas building up inside their bodies until they finally get around to passing some solid waste out along with liquid waste making its way out through their bodies’ systems (this process is called “cystitis”).

You may have a lower or upper urinary tract infection.

If you have a lower urinary tract infection (LUTI), your symptoms may include:

  • Fever and chills
  • Pain when urinating or having sex

If you have an upper urinary tract infection (u/t), your symptoms may include:


Remember, a lower urinary tract infection can cause some of the same symptoms as a u/t infection. However, if you have any of these signs and symptoms, it’s important to seek medical attention immediately.

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