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A 66-year-old woman, Mrs. C., has come with a complaint of recent onset of leaking urine...

A 66-year-old woman, Mrs. C., has come with a complaint of recent onset of leaking urine and she has no such previous history. She has been a widow for 15 years with no sexual partners and is now recently married. She went for a cruise with her husband and she is currently facing difficulty in meeting the daily intercourse needs of her husband. She also complains of general discomfort and burning in vagina.

Her vital signs are 128/76 mm Hg blood pressure (BP), 82 (regular) pulse, 16 breaths per minute respiratory rate, temperature 98.2 °F and body mass index (BMI) of 23.4. She has not known drug allergies and currently takes fish oil at bedtime and vitamin D3 1000 IU daily. She got her urine tested with results include traces of protein and blood and negative for nitrate, ketones, glucose and leukocyte esterase and specific gravity 1.015.

Q1 what additional subjective and objective data that you need?

Q2 What are the differential diagnosis that you are considering?

Q3 Are there any healthy people 2020 objectives that you should consider?

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Answer #1

1. The additional subjective data to be asked us whether she has dribbling of urine everytime or when there is any stress ,sneezing , coughing etc .

Objective assessment - include a detailed examination of vagina for any infection

2. The differential diagnosis are :-

- pelvic muscle weakness

- delirium

- infection

- atrophic vaginitis

- psychological disorder like depression

- pharmaceuticals

- stool impaction

- reduced mobility

- excessive urine output

3. Yes ,there some of the healthy people 2020 objectives that should be considered :-

- access to health services

- immunisation and infectious disease

- cancer

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