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
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Pivotal Concept Addressed |
Category |
Question |
Response |
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• |
HPI |
How can I help you today? |
I’ve been having some pain and burning when I urinate. |
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HPI |
Do you have any other symptoms or concerns we should discuss? |
Yes, I’m also having some vaginal discharge. That’s about it. |
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Symptom |
Do you have vaginal discharge/discomfort? Yup. |
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HPI |
What are the events surrounding the start ofit started around the same time as the your vaginal discharge/discomfort? |
burning with peeing did. |
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• |
HP! |
When did the discharge occur relative to your menstrual cycle? |
This is not related to my period. |
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• |
HP! |
How long does your vaginal discharge/discomfort last? |
It occurs on and off. |
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HP! |
Does your vaginal discharge/discomfort come and go? |
It’s there on and off throughout the day but it’s not going away. |
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• |
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. |
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• |
HPI |
How severe is your vaginal discharge/discomfort? |
Moderate I guess. |
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• |
HP! |
Does anything make your vaginal discharge/discomfort better or worse? |
Not really. |
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HPI |
What treatments have you had for your vaginal discharge/discomfort? |
Nothing really. |
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• |
Symptom |
Do you have pain/discomfort when you urinate? |
Yup. |
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• |
HPI |
When did your pain/discomfort with urination start? |
It started about 2 days ago. |
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HP! |
What are the events surrounding the start of I cannot point to anything specific. your pain/discomfort with urination? |
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• 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
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