Please see sample papers graded with high quality, Make sure
Please see sample papers graded with high quality, Make sure each question is answered with in text citations.A 28 year old G0 calls the office with complaints of lower abdominal pressure and urinary frequency. She has been in the office four times over this past year for dysuria and has been treated for UTI. She is sexually active on Apri for contraception. She has a negative GYN history. She feels her UTI symptoms seem to be occurring within 12 hours of intercourse.PMH – PCOSMedications – Loestrin 1/20, Mvi, Omega 3Allergies – CiprofloxacinVitals: T=98.4, B/P=118/72, Pulse = 84Color, UrineyellowClarity, UrineTurbidpH, Urine5.5Glucose, UrineNegativeProtein, Urine100 mgdLKetones, UrineNegativeBlood, UrineLargeNitritePositiveLeukocytes UrineLargeSpecific Gravity, Urine1.020White Blood Cells, Urine818Red Blood Cells, Urine>900Bacteria, UrineManyHyaline Casts100,000 CFU/ML Escherichia coliEscherichia coli Not SpecifiedAmpicillin<=8 ug/ml SensitiveAmpicillin + Sulbactam<=1/.5 ug/ml SensitiveCefazolin<=2 ug/ml SensitiveCefepime<=2 ug/ml SensitiveCeftriaxone<=1 ug/ml SensitiveCiprofloxacin<=1 ug/ml SensitiveGentamicin<=1 ug/ml SensitiveNitrofurantoin<=32 ug/ml SensitiveTobramycin<=1 ug/ml SensitiveTrimethoprim + Sulfamethoxazole<=2/38 ug/ml SensitiveWhat would you include in your focused physical exam?What diagnostic tests would you include today?What is your interpretation of these results?Would you select to treat this patient?What does MIC mean? How does it influence choosing a treatment?Explain your reasoning for selecting the treatment you chose.What would your choice be if she was pregnant?Explain why women are at higher risk for urinary tract infections.As you finish your visit she asks, “What can I do to prevent this from happening?” How do you answer this question, and what can she do to prevent them from happening in conjunction with sexual relations?References are below with hyperlinksUrinalysis: A Comprehensive Overview – AAFPACOG practice bulletin – Treatment of Urinary Tract Infections in Non-pregnant womenACOG vide- Recurrent Urinary Tract Infection PreventionACOG – FAQ Urinary Tract InfectionsManaging acute UTIs in postmenopausal womenAmerican Cancer Society – Prostate Cancer Screening GuidelinesAmerican Urological Association – Prostate Cancer Screening GuidelinesAmerican Urological Association – Evaluation and Management of Testosterone DeficiencyAmerican Urological Association – Kidney StonesUnited States Preventative Task Force – Prostate Cancer ScreeningAmerican Academy of Clinical Endocrinologists – Reproductive Medicine – Male Sexual DysfunctionAmerican Academy of Clinical Endocrinologists – Reproductive Medicine – Evaluation and Treatment of Hypogonadism in Male Patients
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