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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 UTI treated without sequelae about 1 year agoHabits: 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
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