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Worksheetscase studies 1- Urology
Total questions: 6
Worksheet time: 5mins
What is the differential diagnosis for this set of symptoms? What is your preliminary diagnosis?
Acute cystitis, extensive UTI, vaginitis and urethritis
Acute cystitis
Pelvic Inflammatory Disease
Gonococcal urethritis
What tests should you order to confirm your preliminary diagnosis?
Urine culture & CBC
X-ray KUB
Cystoscopy
Pelvic exam
Laboratory tests indicate a Hgb of 13.6 g/dL, Hct 40.7%, MCV 84, and WBC count 10,910/microliter. White blood cells and bacteria are evident in the urine sediment. A urine culture indicates approximately 106 bacterial cells/ml. A Gram stain of the urine reveals Gram-positive cocci. The Gram-positive bacterium is isolated and is found to be catalase positive and coagulase negative.
Diagnosis of Acute cystitis
Enterococci, group B streptococci
Staphylococci
All of Above
What things must be considered when taking a sample for analysis in a case like this? What instructions should be given to the lab?
Random collection taken at any time of day with no precautions regarding contamination.
Early morning collection of the sample before ingestion of any fluid
Clean-catch, midstream urine specimen collected after cleansing the external urethral meatus
None of the above
What are the possible causes of recurrent lower UTIs? Which of these is most likely in this case?
Lack of personal hygiene
Relapse of old infections
Insufficient duration of antibiotic treatment
Reinfection
None of the above
How should this case be treated?
Short course of antibiotics
Long term prophylaxis(low dose)
High dose of antibiotics
Post intercourse urination
None of the above
