Before Urosepsis sepsis caused by a urogenital tract infection. Infection in any
ID: 141207 • Letter: B
Question
Before Urosepsis sepsis caused by a urogenital tract infection. Infection in any part of your urinary system UTI HISTORY OF PRESENT ILLNESS: The patient is an 81-year-old white woman who was admitted through the emergency department at Stanford Hospital with dehydration, UTI, and vaginitis She was totally uncooperative at the time that I saw her, so the history is pieced together from the emergency department report and past medical records. PAST MEDICAL HISTORY AND SURGERIES: The patient had a fractured leg in 20xo She had a left hip prosthesis. She had a hysterectomy and appendectomy. She was in Marshall Hospital in 20xx with blood clots in the leg and possible pulmonary embolism. She has had consequent problems with easy bleeding MEDICATIONS: Presently, she is taking ampicillin for a urinary tract infection, and the drug Assignment S apparently did not work This was prescribed on August 24. At that time, a Foley catheter was also placed. The patient presented to the emergency department today clinically worsened. She was noted at that time to have a UTI and also a purulent vaginal drainage PHYSICAL EXAMINATION: Vital Signs: T96F. P 80. BP 104/60. HEENT:Severely limited because the patient would not open her eyes or mouth. No lesions were seen. CHEST: Clear although I was not able to listen to all lung fields. BREASTS: Unremarkable. HEART: Regular 5 6Explanation / Answer
Answer 1 As it is in sub title, it is written that patient had purulent vaginal drainage. The word purulent refers to anything consisting of pus. So, the vaginal discharge had pus in it.
Answer 2 Pulmonary embolism is condition when there is a blood clot in pulmonary artery. The patient has got this because she had a history of blood clot in her leg. This clot would have travelled to lungs and had caused pulmonary embolism.
Answer 3 On physical examination of the abdomen of patient, organomegaly which means increase in size i.e. enlargement of organ was not observed. So, there was no organ enlargement in abdomen.
Answer 4 Once it was determined she was dehydrated, Intravenous fluids (IV fluids) were to be administered as a part of action plan. This was done to ensure rehydration.
Answer 5 White blood cell (WBC) count given is 12.1 which mean 12.1 x 109 cells per litre which is high.
The normal range is 4 x 10 9 to 11 x 109 cells per litre. Elevated WBC count indicates that there is some infection.
Answer 6 The specific gravity of urine is 1.025 which it indicates it is within normal range (1.002 to 1.030)
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