Tina Jones Conditions of the Gastrointestinal and Genitourinary Systems
In this activity, you were asked to choose the most appropriate, cost effective, least invasive diagnostic tests to order to help rule in or rule out a diagnosis.
Review of Appropriate Tests:
Sexually Transmitted Infection Panel:
This test is appropriate as the patient is sexually active and has not been tested. The patient’s partner also has not been tested. Considering the patient’s sexual activity with an untested partner, intermittent condom use, and urological symptoms, this test is valuable in this scenario.
Urinalysis:
This test is suitable for determining the origin of the lower abdominal pain the patient is experiencing. Based on the patient’s history, characteristics, and location of the pain, as well as the practitioner’s physical exam findings, a urinalysis is an appropriate choice.
Urine Culture and Sensitivity:
This test will determine the right antibiotic needed for bacteria that will be identified if an infection is suspected. A urine culture and sensitivity are useful in looking for bacteria that are resistant to certain kinds of treatment.
Urine Pregnancy Test:
This test is appropriate to rule out or rule in pregnancy, especially as the patient has a history of PCOS, which is marked by irregular periods. Determining pregnancy is critical to the patient’s health and safety, and this test is inexpensive and suitable for the purpose.
Test Linking:
Sexually Transmitted Infection (STI) Panel:
The patient practices unprotected sex and has not been tested, along with her partner. Abdominal tenderness and age over 25 support the need for an STI panel to rule out sexually transmitted infections.
Cystitis:
Painful urination, abdominal pain, cramping, and urgency support the need for a urinalysis, which has high sensitivity and specificity for ruling in or out cystitis.
Urine Culture and Sensitivity:
This test will assist in prescribing the right antibiotics for treatment. A urine culture will confirm a cystitis diagnosis if determined by a urinalysis and allow for prescribing the correct antibiotic. It also helps rule out pyelonephritis, a serious condition, based on the patient’s symptoms.
Pregnancy:
The patient is sexually active, and determining pregnancy with high sensitivity and specificity is important, especially in sexually active patients of childbearing age. It helps identify whether the patient has a dangerous ectopic pregnancy.
