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Old 07-03-2011
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ObGyn woman with difficulty urinating case

A 30-year-old woman has some difficulty urinating. There is no foul odor to her urine or change in color. She does not have true dysuria, she just urinates more frequently than usual, but denies any pain, loss of bladder control, or waking up at night to urinate. She is sexually active with her husband of 10 years, and they have been trying unsuccessfully to have children. The patient has refused a fertility work-up and feels that if they were meant to have children they will. She has had irregular menses all her life. Examination reveals that she is afebrile and in no distress. She is quite hirsute. The abdominal exam is benign. She has no suprapubic tenderness. The figure shows the results of microscopic examination of her urine. What is the next step in management?


Answer Choices
A. Consider an ultrasound to look for polycystic ovary disease
B. Do a renal biopsy since there is active glomerular bleeding
C. Treat her with allopurinol for hyperuricemia
D. Treat her with IV antibiotics because she has a pyelonephritis
E. Treat her with oral antibiotics and tell her to drink cranberry juice for her urinary tract infection
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Old 07-03-2011
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Quote:
Originally Posted by miss patho View Post
A 30-year-old woman has some difficulty urinating. There is no foul odor to her urine or change in color. She does not have true dysuria, she just urinates more frequently than usual, but denies any pain, loss of bladder control, or waking up at night to urinate. She is sexually active with her husband of 10 years, and they have been trying unsuccessfully to have children. The patient has refused a fertility work-up and feels that if they were meant to have children they will. She has had irregular menses all her life. Examination reveals that she is afebrile and in no distress. She is quite hirsute. The abdominal exam is benign. She has no suprapubic tenderness. The figure shows the results of microscopic examination of her urine. What is the next step in management?


Answer Choices
A. Consider an ultrasound to look for polycystic ovary disease
B. Do a renal biopsy since there is active glomerular bleeding
C. Treat her with allopurinol for hyperuricemia
D. Treat her with IV antibiotics because she has a pyelonephritis
E. Treat her with oral antibiotics and tell her to drink cranberry juice for her urinary tract infection
i think answer is a....pcod cause infertility and may be associated with dm..

she is afebrile so it cant be d and e.....lack of arthritis rule out c..i dont know about b but hematuria should be present..so i think a is answer
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