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IHUMAN CASE STUDY FOR A 16 YEARS OLD
PATIENT - REASON FOR ENCOUNTER: “I’M PEEING
A LOT AND IT HURTS” - WEEK #7 2026 (CLASS 6512)
LOCATION: OUTPATIENT CLINIC WITH X-RAY, ECG,
AND LABORATORY SERVICES
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Case title & summary:
Acute urinary symptoms (frequency + dysuria) in an 16-year-old — evaluation
focuses on distinguishing uncomplicated lower urinary tract infection (cystitis)
from sexually-transmitted urethritis, pyelonephritis, pregnancy-related infection,
nephrolithiasis, metabolic causes (diabetes), and less common causes such as
interstitial cystitis. Includes urgent tests (pregnancy test, urine dip/UA, NAAT for
STIs), empiric therapy considerations, and safety netting.
Reason for encounter:
“Peeing a lot and it hurts” — parent/patient worried; started within past 48 hours,
interfering with school and sleep.
Patient demographics:
Age: 16 years
Sex: female
Height: 5′4″ (163 cm)
Weight: 125 lb (56.8 kg)
BMI: ~21.3 kg/m²
Case mode: Learning mode
Clinic capabilities: X-ray, ECG, point-of-care urine dip, lab UA + culture, NAAT
for chlamydia/gonorrhea, pregnancy testing, basic metabolic panel.
Attempts allowed: Unlimited (learning)
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2) Chief Complaint (CC)
Patient states: “I’m peeing a lot and it hurts.”
Onset: 48 hours ago
Course: progressive — frequency increasing, dysuria persistent
Severity: moderate (interferes with class and sleep)
Key associated complaint to probe: vaginal discharge, fever, flank pain,
nausea/vomiting, sexual activity, new partners, contraception, last menstrual
period (LMP).
3) History of Present Illness (HPI)
Symptom detail: Dysuria (burning at urethral meatus when voiding),
urinary frequency (voiding every 30–60 minutes), urgency, small volumes,
nocturia interrupting sleep. Reports suprapubic pressure, denies gross
hematuria (no visible blood, but may have microscopic). No flank pain at
present. No nausea/vomiting.
Timing: Started 2 days ago after social weekend; no clear trauma.
Associated: Slight malodorous urine per patient; denies fever or chills (take
temp). No skin rash. Reports mild vaginal irritation but no profuse foul
discharge.
Obstetric/menstrual: LMP 10 days ago, regular 28-day cycles. Sexually
active; last intercourse 6 days ago with a new partner; inconsistent condom
use. No current contraception other than condoms.
IHUMAN CASE STUDY FOR A 16 YEARS OLD
PATIENT - REASON FOR ENCOUNTER: “I’M PEEING
A LOT AND IT HURTS” - WEEK #7 2026 (CLASS 6512)
LOCATION: OUTPATIENT CLINIC WITH X-RAY, ECG,
AND LABORATORY SERVICES
, Page |2
Case title & summary:
Acute urinary symptoms (frequency + dysuria) in an 16-year-old — evaluation
focuses on distinguishing uncomplicated lower urinary tract infection (cystitis)
from sexually-transmitted urethritis, pyelonephritis, pregnancy-related infection,
nephrolithiasis, metabolic causes (diabetes), and less common causes such as
interstitial cystitis. Includes urgent tests (pregnancy test, urine dip/UA, NAAT for
STIs), empiric therapy considerations, and safety netting.
Reason for encounter:
“Peeing a lot and it hurts” — parent/patient worried; started within past 48 hours,
interfering with school and sleep.
Patient demographics:
Age: 16 years
Sex: female
Height: 5′4″ (163 cm)
Weight: 125 lb (56.8 kg)
BMI: ~21.3 kg/m²
Case mode: Learning mode
Clinic capabilities: X-ray, ECG, point-of-care urine dip, lab UA + culture, NAAT
for chlamydia/gonorrhea, pregnancy testing, basic metabolic panel.
Attempts allowed: Unlimited (learning)
, Page |3
2) Chief Complaint (CC)
Patient states: “I’m peeing a lot and it hurts.”
Onset: 48 hours ago
Course: progressive — frequency increasing, dysuria persistent
Severity: moderate (interferes with class and sleep)
Key associated complaint to probe: vaginal discharge, fever, flank pain,
nausea/vomiting, sexual activity, new partners, contraception, last menstrual
period (LMP).
3) History of Present Illness (HPI)
Symptom detail: Dysuria (burning at urethral meatus when voiding),
urinary frequency (voiding every 30–60 minutes), urgency, small volumes,
nocturia interrupting sleep. Reports suprapubic pressure, denies gross
hematuria (no visible blood, but may have microscopic). No flank pain at
present. No nausea/vomiting.
Timing: Started 2 days ago after social weekend; no clear trauma.
Associated: Slight malodorous urine per patient; denies fever or chills (take
temp). No skin rash. Reports mild vaginal irritation but no profuse foul
discharge.
Obstetric/menstrual: LMP 10 days ago, regular 28-day cycles. Sexually
active; last intercourse 6 days ago with a new partner; inconsistent condom
use. No current contraception other than condoms.
