S. A 22 yr. old female known to your practice, presents with C/C of “pain when I pass my urine” Also complains of frequency and some urgency. Has noticed symptoms intermittent for past couple of days but in last 24 hrs. Her dysuria has become much worse and prompted her to come in. States she had UTI in past and this “feels like the same thing”. Voiding makes sx worse; nothing helps tho did try Cranberry juice and increasing fluids. Denies fever, chills, nausea, vomiting, back pain, hematuria or change in color of urine. Denies vaginal discharge or itching. Is sexually active, monogamous relationship. Last intercourse 3 days ago, uses condoms. LMP 1 week ago, normal, doesn’t think she could be pg. Eager to be treated and “I want to know how to prevent getting these”.

PMHx: Fx. R wrist as teen

Habits: Smokes less than 1 pack/day, considering quit program at her workplace; no ETOH or street drugs

Allergies: NKDA, no other allergies

Patient Profile: Works at UPS in office, enjoys job. Lives w boyfriend in aprt; feels safe in relationship. Runs or swims 4 times/ week. Views self as generally healthy.

O. Pleasant female, very communicative, able to get on /off exam table s difficulty.

BP 118/78   P 82   T 98.8  BMI 25

Abd. Bowel sounds all quads, no tenderness to light or deep palpation except supra pubic tenderness to light palpation. No CVA tenderness

External genital exam nl. No lesions BUS nl. Pt. prefers defer pelvic

Dipstick : Positive for leukocyte- esterase and nitrates

1. Translate the clinical questions into a searchable question using PICO
   1. Patient, Population or Problem
   2. Intervention or exposure
   3. Comparison
   4. Outcome
   Here is a resource on Libguides for PICO questions.
2. How does evidence support your clinical decision making in considering the following for this patient:
   1. risk factors
   2. history
   3. physical
   4. making the diagnosis
   5. treatment
   6. prevention