i-Human Case Study – Week 7: 16-Year-Old Female
with Dysuria (2025 Version) Focus: Urinary tract
assessment, differential diagnosis, testing
interpretation, and evidence-based treatment
planning.
Patient Presentation & History (Questions 1-25)
1. What is the chief complaint of this patient?
a) Hematuria
b) Lower back pain
c) Dysuria ✓
d) Vaginal discharge
2. Dysuria is best defined as:
a) Painful or difficult urination ✓
b) Blood in the urine
c) Frequent urination
d) Inability to urinate
3. Which of the following is a critical first step in the patient interview?
a) Ordering a CT scan
b) Establishing rapport and ensuring confidentiality ✓
c) Performing a pelvic exam
d) Starting empiric antibiotics
4. When evaluating dysuria in a sexually active adolescent, it is essential to ask about:
a) Favorite school subjects
b) Vaginal discharge, odor, and sexual history ✓
c) Family history of glaucoma
d) Dietary preferences
5. A key question to differentiate a UTI from a sexually transmitted infection (STI) is:
a) "Do you have a fever?"
b) "Are you allergic to any medications?"
,c) "Have you noticed any vaginal discharge or odor?" ✓
d) "How much water do you drink daily?"
6. The patient reports new vaginal discharge. What does this most likely suggest?
a) A classic uncomplicated UTI
b) A possible sexually transmitted infection (STI) like chlamydia or gonorrhea ✓
c) Kidney stones
d) Asymptomatic bacteriuria
7. The patient denies vaginal symptoms. What does this make more likely?
a) Pelvic Inflammatory Disease (PID)
b) Cystitis (UTI) ✓
c) Trichomoniasis
d) Bacterial Vaginosis
8. What is a common risk factor for UTIs in females?
a) High-protein diet
b) Wiping from back to front after toileting ✓
c) Excessive caffeine intake
d) Sleeping for 8 hours
9. What element of the history is crucial for assessing the risk of pyelonephritis?
a) Presence of costovertebral angle (CVA) tenderness or flank pain ✓
b) The color of her urine
c) History of migraines
d) Family history of asthma
10. The patient reports she is sexually active. What is the single most important follow-up
question?
a) The name of her partner
b) Her method of contraception and if she uses barrier protection (condoms) ✓
c) How many partners she has had
d) If she is in a committed relationship
11. What is a "red flag" symptom in a patient with dysuria?
a) Urinary frequency
b) Feeling tired
c) Fever and chills (suggesting systemic infection) ✓
d) Clear urine
, 12. Why is it important to ask about antibiotic use in the past month?
a) To judge her health literacy
b) It can increase the risk of resistance or C. difficile infection ✓
c) To calculate the cost of her care
d) It is irrelevant to the current presentation
13. A history of recurrent UTIs would prompt consideration of:
a) Immediate hospitalization
b) Referral to a urologist for further workup ✓
c) No change in management
d) Long-term antiviral therapy
14. What gynecological history is relevant?
a) Age of menarche
b) Date of last menstrual period (LMP) and regularity ✓
c) History of cosmetic surgery
d) Shoe size
15. The patient's social history should include screening for:
a) Willingness to exercise
b) Tobacco, alcohol, and drug use ✓
c) Favorite social media platforms
d) Career aspirations
16. What question helps assess for urethritis?
a) "Do you have joint pain?"
b) "Is the pain at the start or the end of urination?" ✓
c) "Do you wear cotton underwear?"
d) "How often do you bathe?"
17. What symptom is more characteristic of cystitis than urethritis?
a) Suprapubic pain ✓
b) Dyspareunia (pain with intercourse)
c) Inguinal lymphadenopathy
d) Skin rash
18. Asking about "new soaps, bubble baths, or detergents" is assessing for:
a) Chemical irritants or contact dermatitis ✓
b) Allergic reaction to food
with Dysuria (2025 Version) Focus: Urinary tract
assessment, differential diagnosis, testing
interpretation, and evidence-based treatment
planning.
Patient Presentation & History (Questions 1-25)
1. What is the chief complaint of this patient?
a) Hematuria
b) Lower back pain
c) Dysuria ✓
d) Vaginal discharge
2. Dysuria is best defined as:
a) Painful or difficult urination ✓
b) Blood in the urine
c) Frequent urination
d) Inability to urinate
3. Which of the following is a critical first step in the patient interview?
a) Ordering a CT scan
b) Establishing rapport and ensuring confidentiality ✓
c) Performing a pelvic exam
d) Starting empiric antibiotics
4. When evaluating dysuria in a sexually active adolescent, it is essential to ask about:
a) Favorite school subjects
b) Vaginal discharge, odor, and sexual history ✓
c) Family history of glaucoma
d) Dietary preferences
5. A key question to differentiate a UTI from a sexually transmitted infection (STI) is:
a) "Do you have a fever?"
b) "Are you allergic to any medications?"
,c) "Have you noticed any vaginal discharge or odor?" ✓
d) "How much water do you drink daily?"
6. The patient reports new vaginal discharge. What does this most likely suggest?
a) A classic uncomplicated UTI
b) A possible sexually transmitted infection (STI) like chlamydia or gonorrhea ✓
c) Kidney stones
d) Asymptomatic bacteriuria
7. The patient denies vaginal symptoms. What does this make more likely?
a) Pelvic Inflammatory Disease (PID)
b) Cystitis (UTI) ✓
c) Trichomoniasis
d) Bacterial Vaginosis
8. What is a common risk factor for UTIs in females?
a) High-protein diet
b) Wiping from back to front after toileting ✓
c) Excessive caffeine intake
d) Sleeping for 8 hours
9. What element of the history is crucial for assessing the risk of pyelonephritis?
a) Presence of costovertebral angle (CVA) tenderness or flank pain ✓
b) The color of her urine
c) History of migraines
d) Family history of asthma
10. The patient reports she is sexually active. What is the single most important follow-up
question?
a) The name of her partner
b) Her method of contraception and if she uses barrier protection (condoms) ✓
c) How many partners she has had
d) If she is in a committed relationship
11. What is a "red flag" symptom in a patient with dysuria?
a) Urinary frequency
b) Feeling tired
c) Fever and chills (suggesting systemic infection) ✓
d) Clear urine
, 12. Why is it important to ask about antibiotic use in the past month?
a) To judge her health literacy
b) It can increase the risk of resistance or C. difficile infection ✓
c) To calculate the cost of her care
d) It is irrelevant to the current presentation
13. A history of recurrent UTIs would prompt consideration of:
a) Immediate hospitalization
b) Referral to a urologist for further workup ✓
c) No change in management
d) Long-term antiviral therapy
14. What gynecological history is relevant?
a) Age of menarche
b) Date of last menstrual period (LMP) and regularity ✓
c) History of cosmetic surgery
d) Shoe size
15. The patient's social history should include screening for:
a) Willingness to exercise
b) Tobacco, alcohol, and drug use ✓
c) Favorite social media platforms
d) Career aspirations
16. What question helps assess for urethritis?
a) "Do you have joint pain?"
b) "Is the pain at the start or the end of urination?" ✓
c) "Do you wear cotton underwear?"
d) "How often do you bathe?"
17. What symptom is more characteristic of cystitis than urethritis?
a) Suprapubic pain ✓
b) Dyspareunia (pain with intercourse)
c) Inguinal lymphadenopathy
d) Skin rash
18. Asking about "new soaps, bubble baths, or detergents" is assessing for:
a) Chemical irritants or contact dermatitis ✓
b) Allergic reaction to food
