Patient Instructions — REBECCA WALSH

You are Rebecca Walsh, a 35 year old woman (choose appropriate DoB). Over the past 24 hours you have been feeling feverish but you checked your temperature and it was normal. You are achy, tired and have lower abdominal pain. You feel nauseated but you have not vomited, you have tried drinking cranberry juice.

Your opening statement should be “thank you for seeing me doctor, I’m a bit embarrassed talking about this but it hurts when I go for a wee.”

You have pain when you pass urine and you have noticed that it smells a bit when you pass urine. Your bowels are working well. You have not noticed any blood in your urine. You are passing small amounts of urine often. Often you feel the need to go again soon after going for a wee. When you pass urine it burns and stings. You have aching in your lower stomach over your bladder. No pain in your back or the sides of your abdomen. No vaginal discharge. Abdo pain is central non radiating. Periods are normal no concerns.

You had similar symptoms a few years ago however you were busy with work and you did not seek help straight away. You ended up being admitted to hospital with a kidney infection. This is the first time you have had similar symptoms and you therefore are wanting to treat it quicker than before to prevent becoming so unwell again. They scanned your kidneys at the time and it all looked ok.

S – site – lower central abdominal pain and burning passing urine

Q - quality - ache

I – intensity – 4/10 but you know that it will only get worse from here

T – timing – constant ache

A – aggravating - Worse when you need to pass urine or when you are passing urine.

R - relieving - sitting in a warm bath has helped

Ideas – you think you have another urinary tract infection

Concerns - That you may end up in hospital again

Expectations - for some antibiotics

You have otherwise no past medical history, surgical history. Your father has type 1 diabetes. Your mother had breast cancer last year when she was 65. She is doing ok now following treatment. You do not take any medication regularly however you have had 2 paracetamols today to help with the pain and you tried an over the counter sachet for cystitis to see if that would help but it hasn’t. You are not allergic to anything that you are aware of.

You work as a legal secretary. You are sexually active, your husband is your only sexual partner. He has no symptoms and is well. You have never had any sexually transmitted infections and you use condoms. You do not smoke and only drink 1-2 units of wine a month when you go out to dinner.

You will not be expected to be examined and should come dressed in comfy clothes as you feel a bit feverish and sore.

Your demeanour is friendly and approachable. You should answer questions as they are asked i.e. if it is an open question then answer openly, if it is a closed question then please answer with a yes/no/maybe. Only give information when it is specifically asked. Please be fairly succinct as the students only have 6 minutes for this.