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Critical Thinking Clinical Cases

Critical Thinking Clinical Case: 24 Year-Old Female

John Bielinski, MS PA-C By October 24, 2022No Comments

Case

A 24 year-old female presents with dysuria, “I think I have a UTI.” UA is attached. Infected? If so, what antibiotic would you use?

Solution

This is a bit tricky. I don’t see the enzyme around the WBC (leukocyte esterase) yet I see WBCs under the microscope. BUT, there are 30-40 epi cells, that means the patient didn’t clean themselves off well. So, this urine has little value.

When we look at predictive values for UTI, the following chart may be helpful.

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