BRIANNA GILL. 28-YEAR-OLD
FEMALE. REASON FOR
ENCOUNTER: PAIN WHEN I
PEE. WITH A SOAP NOTE
EXAM STUDY GUIDE. GRADED
A+. LATEST 2026/2027
UPDATE.
,HISTORY
History of Present Illness (HPI):
• Briana Gill is a 28-year-old female presenting with pain and burning
during urination for the past 3 days.
• Symptoms began gradually and have become more noticeable over the
last several days.
• Describes the pain as a burning sensation occurring primarily during
urination.
• Rates discomfort as moderate in severity.
• Reports increased urinary frequency.
, • Feels the urge to urinate more often, even when only small amounts of
urine are passed.
• Notes urinary urgency and difficulty delaying urination once the urge
occurs.
• Reports mild suprapubic discomfort.
• States symptoms are interfering with daily activities and causing
discomfort throughout the day.
• Has been drinking more water in an attempt to relieve symptoms with
minimal improvement.
• Denies previous treatment for the current episode.
Associated Symptoms:
• Dysuria
• Urinary frequency
• Urinary urgency
• Mild lower abdominal/suprapubic discomfort
Denies:
• Fever
• Chills
• Nausea
• Vomiting
• Flank pain
• Vaginal bleeding
• Vaginal discharge
• Haematuria
• Back pain
• Pelvic trauma