Question #10 explained:
FT is a 37 year-old female patient who presents to an urgent care doctor. FT reports dysuria, frequency, urgency, fever, flank pain, nausea, and headache. Prior to the physical examination, the medical doctor comments that he believes she likely has pyelonephritis. What two symptoms likely led the physician to believe pyelonephritis is present?
A. Headache and flank pain
B. Fever and flank pain CORRECT
C. Fever and dysuria
D. Headache and dysuria
The combination of symptoms present points the clinician towards pyelonephritis, but the presence of fever (something not commonly seen with lower UTI) plus flank pain (also known as costvertebral angle tenderness [CVA tenderness, CVAT], something commonly associated with a kidney infection) are key triggers towards indicating potential pyelonephritis. If the patient additionally was experiencing hypotension, tachycardia, respiratory distress, and/or leukocytosis, a diagnosis of urosepsis with pyelonephritis may be warranted.