I HUMAN WEEK 7 OF KRISTINA HART HAVING PAIN IN URINE
Patient Profile Kristina Hart
Demographics History of Present Illness (HPI) Medical & Social History
Name: Kristina Patient reports a 3- PMH: Recurrent UTIs (3 episodes in the last 2 years). Social: Non-smoker;
Hart Age: 28 day history of sexually active with one partner; works as a graphic designer.
Gender: Female increasing urinary
Chief Complaint: frequency and
"It burns when I urgency. She
pee and I'm going describes a sharp,
all the time ." burning sensation
during urination
(dysuria) and
persistent
suprapubic pain.
Clinical Findings: Physical Examination
Assessment Category Clinical Data
Vital Signs Temp: 98.9°F | BP: 122/78 mmHg | HR: 76 bpm | RR: 14 bpm
Abdominal Exam Soft, non-distended. Significant tenderness to palpation in the suprapubic region. N
CVA tenderness noted.
, General Appearance Alert and oriented x3. Appears in mild discomfort during position changes.
Laboratory Results: Urinalysis (Clean Catch)
Component Result
Color / Clarity Cloudy, dark yellow
Nitrites Positive
Leukocyte Esterase Positive (2+)
Bacteria Many
WBC / RBC WBC: 20-30/hpf; RBC: 0-2/hpf
Clinical Significance: UA Markers
• Nitrites: Most common UTIs are caused by Gram-negative
bacteria (like E. coli) that produce an enzyme converting dietary nitrates into nitrites. A positive
result is highly specific for a bacterial infection.
• Leukocyte Esterase: This enzyme is produced by neutrophils
(white blood cells). Its presence in the urine indicates pyuria (WBCs in urine), which is a
hallmark of the inflammatory response to a urinary tract infection.
Critical Thinking: Clinical Correlation Based on Kristina's HPI and laboratory findings, explain why
the absence of CVA (costovertebral angle) tenderness is a significant finding in narrowing the diagnosis.
Clinical Correlation Key
Patient Profile Kristina Hart
Demographics History of Present Illness (HPI) Medical & Social History
Name: Kristina Patient reports a 3- PMH: Recurrent UTIs (3 episodes in the last 2 years). Social: Non-smoker;
Hart Age: 28 day history of sexually active with one partner; works as a graphic designer.
Gender: Female increasing urinary
Chief Complaint: frequency and
"It burns when I urgency. She
pee and I'm going describes a sharp,
all the time ." burning sensation
during urination
(dysuria) and
persistent
suprapubic pain.
Clinical Findings: Physical Examination
Assessment Category Clinical Data
Vital Signs Temp: 98.9°F | BP: 122/78 mmHg | HR: 76 bpm | RR: 14 bpm
Abdominal Exam Soft, non-distended. Significant tenderness to palpation in the suprapubic region. N
CVA tenderness noted.
, General Appearance Alert and oriented x3. Appears in mild discomfort during position changes.
Laboratory Results: Urinalysis (Clean Catch)
Component Result
Color / Clarity Cloudy, dark yellow
Nitrites Positive
Leukocyte Esterase Positive (2+)
Bacteria Many
WBC / RBC WBC: 20-30/hpf; RBC: 0-2/hpf
Clinical Significance: UA Markers
• Nitrites: Most common UTIs are caused by Gram-negative
bacteria (like E. coli) that produce an enzyme converting dietary nitrates into nitrites. A positive
result is highly specific for a bacterial infection.
• Leukocyte Esterase: This enzyme is produced by neutrophils
(white blood cells). Its presence in the urine indicates pyuria (WBCs in urine), which is a
hallmark of the inflammatory response to a urinary tract infection.
Critical Thinking: Clinical Correlation Based on Kristina's HPI and laboratory findings, explain why
the absence of CVA (costovertebral angle) tenderness is a significant finding in narrowing the diagnosis.
Clinical Correlation Key
