Level 2: Back Pain – Contrasting Case #1: Patient Information – NEED IMAGE

Given these changes from the original case, what is your diagnosis?

What is your diagnostic explanation?

As compared to the long case, this patient is a 35 year old female. She appears to be in an extreme amount of discomfort.

HPI: Patient states that over the past few days she has been having low back pain. She describes the pain as colicky in nature, as it is a sharp pain and comes and goes. She denies fevers, chills, nausea/vomiting. She states that she occasionally notices increase in pain when she tries to urinate. She works as a surgeon and is very busy during the day. Her diet consists of small meals when she has time, and she drinks mostly coffee.

PMH: No known drug allergies. No current medications.

SH: Non -smoker. Occasional Alcohol. 8 servings of caffeine a day. Married.

FMH: Mother had hypertension and diabetes. Father had hypertension and coronary artery disease.

ROS: No findings

PE –
VS: Height 5’5; Weight 150 lb; BMI 25; HR 82; BP 140/90; RR 16; 98.5F
Cardiac: S1 and S2 audible. Regular rate and rhythm. No murmurs
Lungs: Clear to auscultation bilaterally. No adventitious sounds present.
Abdomen: Soft, nontender, nondistended. No organomegaly present. Exquisite CVA tenderness on right side.

Urinalysis and CT imaging indicating kidney stone.
Urinalysis: 2+ blood in urine, no bacteria or crystals noted