Jane Wheels Year Question & Answer Guide (With Explanation)
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Original Question
Jane Wheels is a 24-year-old married female who presents to her nurse practitioner reporting lower abdominal pain, cramping, slight fever, and dysuria of 4 days duration. History 24-year-old P 1001, LMP 2 weeks ago (regular without dysmenorrhea) She uses oral contraceptives (for 2 years). She reports a gradual onset of symptoms of lower bilateral abdominal discomfort, dysuria (no gross hematuria), abdominal cramping, and a slight low-grade fever in the evenings for 4 days. Discomfort has gradually worsened. Denies GI disturbances or constipation. Denies vaginal discharge. Took Tylenol for fever x 3. Jane states that she is happily married in a mutually monogamous relationship and plans another pregnancy in about 6 months. Husband does not use condoms. Reports that they engage in sexual intercourse approximately 2 times per weekâno oral or rectal sex. Cooperative and good historian. Non-smoker, exercises regularly, no appetite changes, no travel outside the U.S., and no history of STDs. Reports occasional yeast infections. What should be included in the differential diagnosis? Which laboratory tests should be performed or ordered? Laboratory Results of office diagnostics: Urine pregnancy test: negative Urine dipstick for nitrates: negative Vaginal saline wet mount: vaginal pH was 4.5. Microscopy showed WBCs >10 per HPF, no clue cells, no trichomonads and the KOH wet mount was negative for budding yeast and hyphae. What is an appropriate CDC-recommended therapeutic regimen for Ms. Wheels? please provide 2-3 peer review reference Thank you
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