NR577 Week 3 iHuman: Brianna Gill

History Feedback

Ask relevant problem-focused questions to create an accurate initial differential diagnosis list. Various questions may yield the same information. Examples of high-yield questions for this case include:

• Performed X Missed

Pivotal Concept Addressed	Category	Question	Response
•	HPI	How can I help you today?	I’ve been having some pain and burning when I urinate.
	HPI	Do you have any other symptoms or concerns we should discuss?	Yes, I’m also having some vaginal discharge. That’s about it.
	Symptom	Do you have vaginal discharge/discomfort? Yup.
	HPI	What are the events surrounding the start ofit started around the same time as the your vaginal discharge/discomfort?	burning with peeing did.
•	HP!	When did the discharge occur relative to your menstrual cycle?	This is not related to my period.

•	HP!	How long does your vaginal discharge/discomfort last?	It occurs on and off.
	HP!	Does your vaginal discharge/discomfort come and go?	It’s there on and off throughout the day but it’s not going away.
•	HPI	What is the appearance, smell, texture and quantity of the vaginal discharge?	It’s yellow. And thick. I really wish I didn’t have it. I haven’t noticed a smell.
•	HPI	How severe is your vaginal discharge/discomfort?	Moderate I guess.
•	HP!	Does anything make your vaginal discharge/discomfort better or worse?	Not really.
	HPI	What treatments have you had for your vaginal discharge/discomfort?	Nothing really.
•	Symptom	Do you have pain/discomfort when you urinate?	Yup.
•	HPI	When did your pain/discomfort with urination start?	It started about 2 days ago.
•	HP!	What are the events surrounding the start of I cannot point to anything specific. your pain/discomfort with urination?

• Diagnosis Feedback

Cervicitis

Around 70% of chlamydial infections are asymptomatic or mildly symptomatic. When patients do express symptoms, their symptoms represent the anatomical extent of infection.

Patients with cervicitis present with vaginal discharge, post-coital or abnormal vaginal bleeding and sometimes abdominal pain.
Patients with pelvic inflammatory disease are more likely to have abdominal or pelvic pain, dyspareunia, fever, nausea, and vomiting.
Female patients with urethritis (15% of those with chlamydia) present with dysuria and frequency, often mistaking their symptoms for a bladder infection.
Other less likely areas of infection include perihepatitis and reactive arthritis.
C. trachomatis serovars L1-L3 typically lead to lymphogranuloma venereum and painful buboes…………………………purchase the entire simulation at $30 only