Question

question 8 (mandatory) (1 point)
listen
a 27-year-old female presents in your office complaining of constant urgency to urinate, burning upon urination, and foul smelling urine. her urine is cloudy and the urinalysis reveals negative nitrites and positive for leukocyte esterase.
what is the diagnosis?
a) chlamydia
b) urinary tract infection
c) acute glomerulonephritis
d) pyelonephritis
e) nephrotic syndrome

Explanation:

• Chlamydia: Usually presents with genital discharge, pain during intercourse, etc. rather than the urinary - specific symptoms like urgency, burning on urination, and cloudy urine described here.
• Urinary tract infection (UTI): Classic symptoms include urinary urgency, dysuria (burning on urination), and sometimes cloudy or foul - smelling urine. Leukocyte esterase is an enzyme produced by white blood cells, and its presence in urine indicates an inflammatory process (such as infection). Negative nitrites can occur in UTI (especially if the causative organism is not a nitrate - reducing bacteria like E. coli in some cases).
• Acute glomerulonephritis: Typically presents with hematuria (blood in urine - often cola - colored), proteinuria, edema, and hypertension rather than the lower urinary tract symptoms (urgency, dysuria) seen here.
• Pyelonephritis: Usually has more systemic symptoms like fever, chills, flank pain in addition to urinary symptoms. While it can have some overlap with UTI, the lack of systemic symptoms makes UTI more likely.
• Nephrotic syndrome: Characterized by massive proteinuria, hypoalbuminemia, edema, and hyperlipidemia. Urinary symptoms like urgency and dysuria are not typical.

Answer:

B. Urinary tract infection