Posted: January 28th, 2023
Tina Jones Conditions of the Gastrointestinal and Genitourinary Systems Shadow health
Tina Jones Conditions of the Gastrointestinal and Genitourinary Systems Shadow health
Differential Selection : 2 of 2 (100.0%)
In this activity, you were asked to identify which differential diagnoses were essential to investigate to ensure patient safety. You were automatically evaluated by the simulation on whether or not you identified the appropriate list of Do-Not-Miss diagnoses.
Review the list of most appropriate Do-Not-Miss diagnoses below. Correct selections have been marked with a , while selections you missed have been marked with a Tina Jones Conditions of the Gastrointestinal and Genitourinary Systems Shadow health.
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| Do Not Miss | Student Rationale | Model Rationale |
|---|---|---|
Pregnancy
|
the patient is sexually active , the patient is of child bearing age, having unprotected sex | This differential must be considered because the patient is a sexually active woman of childbearing age. Determining whether the pregnancy is intrauterine or extrauterine is of critical importance. If gone untreated, an ectopic pregnancy can cause serious blood loss, organ damage, or other life-threatening conditions. |
Pyelonephritis
|
pain in the lower abdomen, urination urgency | Fever and urgency of urination can all be signs of a more developed urinary tract infection or sudden and severe onset of pyelonephritis. This infection requires immediate treatment to ensure the health of the kidneys and safety of the patient. |
Other Differentials
You were asked to select other potential differential diagnoses that you thought were applicable to the case. Review the list of differential diagnoses below and compare your answers to Diana’s list. Your selections in this section are not automatically scored by the simulation, but your instructor may choose to grade this list.
| Differential | Student Rationale | Model Rationale |
|---|---|---|
Cystitis
|
burning with urination, urinary urgency | According to The American Urological Association, a shorter distance between the anus and the urethra makes cystitis extremely common in women. Comorbidities, such as diabetes, and recent sexual intercourse can increase the risk of cystitis. The patient’s discomfort, urgency of urination, burning with urination, and lower abdominal pain are common signs of a urinary tract infection. |
Nephrolithiasis
|
urinary urgency, abdominal pain | While most common symptoms of nephrolithiasis include renal colic and hematuria, patients can also present with unspecified abdominal pain or frequency and urgency of urination. |
Ruptured Ovarian Cyst
|
patient reports history of PCOS, lower abdominal pain, and aptient is of reproductive age | This selection is a plausible differential as evidenced by the patient’s history of polycystic ovary syndrome (PCOS), lower abdominal pain, and reproductive age. Treatment may vary depending on the severity of the patient’s condition. |
Sexually Transmitted Infection
|
patient is having pain with urination, indulges in unprotected sex, lower abdominal pain | This differential must be considered given the patient’s potential exposure to sexually transmitted infections due to recent unprotected sex with her boyfriend. Painful urination, and lower abdominal pain can be signs of a sexually transmitted infection. |
Test Selection : 4 of 4 (100.0%)
In this activity, you were asked to choose the most appropriate, cost effective, least invasive diagnostic tests to order to help rule in or rule out a diagnosis.
Review the list of appropriate tests below. Correct selections have been marked with a , while selections you missed have been marked with a .
| Selected Test | Student Rationale | Model Rationale |
|---|---|---|
Sexually Transmitted Infection Panel
|
The patient is sexually active, and has not been tested. She is alos above 25 and needs to be tested for chlamydia and gonorrhea. The patient’s partner also has not been tested Tina Jones Conditions of the Gastrointestinal and Genitourinary Systems Shadow health | According to the CDC’s Recommendations for Providing Quality Sexually Transmitted Diseases Clinical Services (2020), “Obtaining a sexual history and assessing risk for STDs include the five Ps (i.e., partners, practices, protection, past STDs, and prevention of pregnancy).” Based on the patient’s current sexual activity with an untested partner, intermittent condom use, and urological symptoms, this is a valuable selection for this scenario. |
Urinalysis
|
lower abdominal pain. This test is appropriate to determine the origin of the lower abdomila pain | According to the American College of Gastroenterology, the patient’s history, the characteristics and location of the pain, and the practitioner’s physical exam findings determine the needs and invasiveness of the test. Based on the information given and the patient’s urological symptoms, a urinalysis is an appropriate choice for gathering evidence about the source of the patient’s lower abdominal pain. |
Urine Culture and Sensitivity
|
This test will determine the right antibiotic needed for bacteria that will be identified | If an infection is suspected, a urine culture and sensitivity is useful in looking for bacteria that are resistant to certain kinds of treatment. Tina Jones Conditions of the Gastrointestinal and Genitourinary Systems Shadow health |
Urine Pregnancy Test
|
unprotected sex, child bearing ag. This test is inexpensive and is appropraite to rule out or rule in preganancy especially as the patient has a history of PCOS which is marked by irregular periods and as such patient may be pregnant and have no symptom,. Therefoer there is need for rule out, | In addition to the signs and symptoms, patients with a history of polycystic ovary syndrome may experience irregular periods, which can make it harder to identify symptoms of pregnancy. If the pregnancy test results are positive, determining whether it is intrauterine or ectopic is critical to the patient’s health and safety. |
Test Linking : 4 of 4 (100.0%)
In this activity, you were asked to link each selected diagnostic test to a differential it helps to investigate.
Review the most appropriate diagnostic test selections below. Correct selections have been marked with a , while selections you missed have been marked with a .
| Test | Student Rationale | Model Rationale |
|---|---|---|
| Sexually Transmitted Infection Panel You Selected: Sexually Transmitted Infection
|
Patient practices unprotected sex, and has not been tested as well as her partner. She also reports abdominal tenderness, and she is above 25 years old thus she needs to be tested for chlamydia and gonorrhea. Alll of these support the need to run an STI panel
Tina Jones Conditions of the Gastrointestinal and Genitourinary Systems Shadow health |
Sexually Transmitted Infection : Ms. Jones’ painful urination, suprapubic tenderness, and inconsistent condom use with an untested partner all support an STI panel to rule out sexually transmitted infections in accordance with the CDC’s 2015 Guidelines. As a sexually active woman over 25, it is particularly important to test Ms. Jones regularly for chlamydia and gonorrhea. |
| Urinalysis You Selected: Cystitis
|
painful urination, abdominal pain, cramping and urgency. This test has high sensitivity and specificity Tina Jones Conditions of the Gastrointestinal and Genitourinary Systems Shadow health | Cystitis : A urinalysis has high specificity and sensitivity for ruling in or out cystitis. |
| Urine Culture and Sensitivity You Selected: Pyelonephritis
|
Will assist in prescribing the right antibitotics for treatment, | Cystitis : A urine culture will confirm a cystitis final diagnosis if one is determined by a urinalysis. It will also allow for prescribing the correct antibiotic. Pyelonephritis : Tina’s lack of CVA tenderness does not rule out pyelonephritis and her other symptoms support it as a differential. Therefore, she must receive a urine culture to rule out this serious condition. |
| Urine Pregnancy Test You Selected: Pregnancy
|
Patient is sexually active, indulge in unprotected sex. This test is needed to determine if patient is pregnant and possibly rule out possibilities of ectopic pregnancy | Pregnancy : A pregnancy test will quickly rule in or out pregnancy with high sensitivity and specificity. Determining whether or not a patient is pregnant will help determine if the patient has a dangerous ectopic pregnancy, which is important in sexually active patients of childbearing age
Tina Jones Conditions of the Gastrointestinal and Genitourinary Systems Shadow health |
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