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Gina presents with pain on urination. When asked she mentions really needing to go and having very little urine in comparison to the urgent need she has to urinate. She also mentions that she has suprapubic pain just before urination and that it seems like she is urinating more frequently. Her vital signs are all normal. Examination of the genitalia did not reveal any lesions on the external genitalia. No vaginal discharge was observed. The patient refused a pelvic exam. A dipstick test of her urine was positive for leukocyte esterase and nitrites. Urine pH was 6.5.
A. Which of the following is the most appropriate diagnosis for Gina's current condition?
B. Which of the following is the most likely cause of her current condition?
C. If her urine pH had been 8.0 then which of the following would have been the most likely cause of her current condition?
D. If her dipstick tests were positive for leukocyte esterase but negative for nitrites and the pH had been 6.5 then which of the following would have been the most likely cause of her current condition (note the organism in the urine this time was catalase positive)?
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Neal Chamberlain, PhD. A. T. Still University of Health Sciences/Kirksville College of Osteopathic Medicine.
Take Care and Think Microbiologically!