A female patient presents at a walk-in clinic. She has been experiencing back pain, along with painful urination, chills and nausea for the past two days. She recently came home from a camping trip where she and her boyfriend hiked for three days. The trip was great, although the weather was hot and sunny.
Prior to the trip she had been urinating frequently and with some pain, and was given antibiotics by another doctor. She took them for three days prior to the camping trip and was feeling much better, so when she forgot to pack them for the trip, she wasn’t worried.
How do you interpret her case?
DownHouseSoftware 
Nicki Tschantz
April 26, 2015 at 1:32 am
She has either a urinary tract infection or bladder / kedney infection and because she didn’t take all her antibiotics it has gotten worse.
Nicki Tschantz
April 26, 2015 at 1:34 am
Wait dehydration due to the heat lol I don’t know
downhousesoftware
April 26, 2015 at 7:39 am
And a Kidney infection is called what?
Nicki Tschantz
April 26, 2015 at 12:06 pm
pyelonephritis
downhousesoftware
April 26, 2015 at 3:19 pm
and it’s good for points.
Nicki Tschantz
April 26, 2015 at 4:07 pm
Awesome
ratabago
May 1, 2015 at 9:49 pm
(Ratabago dons his +3 cap of petty evilness)
She’s pregnant.
— This explains the back pain and nausea.
— She has an unusually early onset of gestational diabetes, the associated ketoacidosis being responsible for the painful urination.
— Either, or both, the pregnancy and the diabetes could explain the chills. (Medicine seems to deny chills are associated with early pregnancy, but an awful lot of pregnant women have insisted it can be).
— The reduction in (perceived) symptoms on taking antibiotics is simply due to placebo effect.
(Taking off my pretty hat for a while)
I think Nicki’s diagnosis is way more likely to be right than mine. But I did have a friend who’s first pregnancy was very much like this. Except she didn’t go camping, and went through 2 courses of antibiotics before they worked out she was pregnant, they seemed to reduce all her symptoms. She had a very irregular cycle, and 8 weeks between periods was not unusual for her. She had also been losing lots of weight. Apparently that threw everybody off. She showed these symptoms for all four of her pregnancies, coming down with gestational diabetes in the first 6 to 8 weeks each time. Sometimes it sucks having a sample space of one. I don’t know how doctors cope with it.