Week 4 Advanced Patho Essay

WEEK 4 ADV PATHO ESSAY Urinary tract infection- this is the most likely diagnosis. The signs and symptoms of a urinary tract infection are pain or burning when you urinate, fever, tiredness or shakiness, an urge to urinate often, pressure in your lower belly, urine that smells bad or looks cloudy or reddish and pain in your back or side below the ribs. Interstitial cystitis- this is a chronic condition in which you experience bladder pressure, bladder pain and sometimes pelvic pain, ranging from mild discomfort to severe pain. The symptoms include chronic pelvic pain, a persistent, urgent need to urinate, frequent urination, often of small amounts, throughout the day and night and pain or discomfort while the bladder fills and relief after urinating (Kurowski, 1998). Vaginal infection – vaginal infection has dysuria, urgency and pubic pain, along with vaginal itching and discharge. Urinary calculi- the first symptom is hematuria or either gravel or a calculus in the urine. Other patients may have symptoms of a UTI, such as fever, dysuria, or cloudy or foul-smelling urine (Nerli, Jali, Guntaka, Patne, Patil , & Hiremath, 2015). Some risk factors for a UTI, the most likely diagnosis, is being a woman, giving the fact that our urethras are shorter than men, which allows bacteria to reach the bladder easier. Being sexually active also increases the likelihood of getting a UTI. Other causes like having to have a urinary catheter and anatomy abnormalities can increase the likelihood of getting a UTI as well. Treatment for a UTI is usually oral antibiotics, unless the UTO is more sever which then IV antibiotics would be used. Detweiler, K., Mayers, D., & Fletcher, S. G. (2015). Bacteruria and Urinary Tract Infections in the Elderly. Urologic Clinics of North America, 42(4), 561-568. Palmeira-de-Oliveira, R., Palmeira-de-Oliveira, A., & Martinez-de-Oliveira, J. (2015). New strategies for local treatment of vaginal infections. Advanced drug delivery reviews, 92, 105-122. Kurowski, K. (1998). The woman with dysuria.American family physician, 57, . Nerli, R., Jali, M., Guntaka, A. K., Patne, P., Patil, S., & Hiremath, M. B. (2015). Type 2 diabetes mellitus and renal stones. Advanced Biomedical Research, 4, 180. The differential diagnosis that correlates with symptoms presented by the 56 year old female is Urinary Calculi. Urinary calculi are crystalline mineral deposits that form in the kidney. They develop from microscopic crystals in the loop of Henle, the distal tubule, or the collecting duct, and they can enlarge to form visible fragments (Pietrow & Kerellas, 2007). Because calculus movement is associated with obstruction of a hollow viscus, many patients suffer from associated nausea, with or without emesis. A dilated ureter, called occurs because an obstruction somewhere is causing the fluid to back up causing the ureter to become dilated. Any abnormal dilatation of the ureter is generally referred to as Megaureter. It is classified as obstructed, refluxing or non-refluxing and unobstructed (Dixit & Narvekar, 2013). A dilated ureter can be another sign and symptom of urinary calculi, which is why I would not change my differential. According to Portis and Sundaram, although narcotics such as codeine, morphine and meperidine (Demerol) are effective in suppressing pain, they do nothing to treat its underlying cause, and they have the side effects of dependence and disorientation. As a result of combined anti-inflammatory and spasmolytic effects, nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, diclofenac (Voltaren) and ibuprofen (e.g., Motrin) can be effective in managing the pain. Dixit, N., & Narvekar, N. (2013, June). A rare case of hydroureter diagnosed during routine fertility investigation: diagnosis by ultrasound and further management. In BJOG-AN International Journal of Obstetrics and Gynecology (Vol. 120, pp. 194-195). Pietrow, P. K., & Karellas, M. K. (2007). Medical management of common urinary calculi. South African Family Practice, 49(3), 44-48. Portis, A. J., & Sundaram, C. P. (2001). Diagnosis and initial management of kidney stones.American family physician, 63(7), . In young nonpregnant women, dysuria, frequency, urgency, suprapubic pain, or hematuria, particularly in the absence of vaginal symptoms, are highly suggestive of a urinary tract infection. The probability of cystitis is greater than 50 percent in women with any symptom of urinary tract infection and greater than 90 percent in women who have dysuria and frequency without vaginal discharge or irritation (Hooton, Gupta, Calderwood, & Bloom). I personally chose a UTI as my number one diagnosis, just from the symptoms. Upon reading a couple of articles, it is said that acute cystitis can go undetected at times due to the symptoms mirroring other issues that can be going on with the body. Hooton, T. M., Gupta, K., Calderwood, S. B., & Bloom, A. (2012). Acute uncomplicated cystitis and pyelonephritis in women.