• Skip to main content
  • My Training Programs
  • Articles and Tutorials
    • The Fitness Index
    • Nutrition Index
    • Inspirational Index
    • Science Index
  • About Antranik
    • About Antranik
    • Online Coaching
  • Members Area
    • Login
    • Account
    • Quick and Effective Strength
    • Smart Core
    • Work From Home Fitness
    • Hypertrophy
    • Rings Routine
    • Easy Hamstrings
    • Hip Flexibility
    • Shoulders & Upper Back
    • Front Splits Fast

Antranik.org

Strength & Flexibility Expert

Like! Follow! Subscribe!

  • Facebook
  • Instagram
  • YouTube

Analyzing a Case History

In this post we’re going to analyze a chart the best we could to get you acquainted with what all this means.

click the image for the larger view if you can’t read this or press ctrl +

Look at the top left where it says CC, that’s the Chief Complaint.  It says there DYSURIA which refers to painful urination.  It also says HEMATURIA (blood in urine) and urinary frequency and urinary hesitancy (nothing comes out).  Right off the bat, this is incredibly suspect of a Urinary Tract Infection.

To the right of that you have Triage Notes and Assessment which include blood pressure, pulse, oxygen saturation (SpO2) and so forth.  Below that we have the circulatory assessment where you could the skin related things look normal.  The normal capillary refill means that when you squeeze your nail (must be free of nail polish), it turns white and when you let off it returns back to a pink color in less than 2 seconds, indicating good blood flow.  If the capillary refill was delayed it may be an indication of septic shock.  Septic shock is a serious condition that occurs when an overwhelming infection leads to life-threatening low blood pressure.

Just below the circulatory assessment, on the right side is the GCS Scale.  The Glasgow Coma Score is part of the test to know how conscious the patient is so that you know what the patients state is like when they took down the info.  The higher the awareness is, the higher the score.  Note that on this chart the highest numbers are circled.

Below the GCS we see a receipt on the right that includes the “dipstick” data for the urine test. A dipstick (a thin, plastic stick with strips of chemicals on it) is placed in the urine to detect abnormalities. The chemical strips change color if certain substances are present or if their levels are above normal.

Handwritten on it it says ICON (-) NEG, and that means she is not pregnant so pain is not relevant to pregnancy.
The COLOR (of the urine) is dark red.
GLU is negative and indicates glucose in urine (diabetic?)
BIL is negative and indicates presence of bilirubin (liver damage?)
KET is negative and indicates presence of ketone bodies (diabetic?)
SG is the isolation of specific gravity and is a way to dissolve the material in the urine (the heaviness of the solution).
The pH is not relevant.
The PRO (protein) is elevated at >=300ms/dl.  You don’t walk around with a lot of protein unless your kidneys are having issues or UTI or something else.
The NIT (Nitrite) is positive and typically indicates large numbers of bacteria.

The blood in the urine is what strongly suggests the diagnosis is UTI.

UTI’s are defined quantitatively.  UTI is defined as ≥100,000 CFU/mL (OR ≥105 CFU/mL).

Colony forming units, usually abbreviated as CFU, refer to individual colonies of bacteria, yeast or mold. A colony of bacteria or yeast refers to a mass of individual cells of the same organism, growing together.

For example: If a microliter of urine (1/1000th of a milliliter) produces 100 colonies on a plate, it can be assumed that a milliliter would have produced 1000 times as many (100,000) and that that corresponds to 100,000 CFU/mL which is apparently the lower limit of contamination for a UTI.

By just getting the dipstick, you don’t even need for the lab results to arrive back.  That’s what a case history does.

Signs versus Symptoms

A complete and detailed examination of the patient needs to occur because you can’t treat unless you know what the problem is.  In taking a medical history, the clinician asks questions such as “Do you have any pain? “Where is the pain?” and “When did you become ill?”  These questions reveal the person’s symptoms.  The symptoms are patient experience.  By contrast, signs are typically quantifiable. They are objective.  They are established by the health care professional and they are definitive.  Body temperature, pulse, blood pressure, and respiratory rate are the four vital signs.

Pain symptoms are felt by the patient and are therefore subjective.  They are immensely variable.  However, you can quantify relevant pain from a 1-10 rating where 1 is minimum and 10 is severe.  If you look at the bottom of the chart above, you will find “Pain Assessment” with the number “4” circled.  Since it can be quantified empirically, pain is regarded as the 5th vital sign.  So the chart we looked at has both signs and symptoms.  Both are necessary for creating a diagnosis but which one do you think is more important?

The symptoms are important but patients don’t always have the intellect to convey how they feel.  The diagnosis is dominated by signs because they are quantifiable, measurable, and they are established by the health care professional so they are accurate.  This is why nurses always get the vitals.  They don’t ask the patient “Are you chipper?  How’s your mood?”  You can’t tell if they are feeling ill or just in a bad mood, especially in a hospital.  So symptoms are weaker on the diagnosis weigh in because you must treat empirically.

Want To Get Strong and Flexible? 💪 Check Out My Programs!

Antranik’s Hypertrophy Routine

This training routine is focused largely on increasing strength and muscle mass (aka muscular hypertrophy). If I had to sum up the routine in one fell swoop I … [Read More]

The Ultimate Flexibility Bundle

I have three premium flexibility programs that I offer and many of you have been clamoring for a bundle-package, so here it is! You could now buy the … [Read More]

Antranik’s Smart Core Program

I don't know about you but nothing gets me fired up more than working on my abs. It's a unique muscle group that is utilized in every exercise and making it … [Read More]

Antranik’s Hip Flexibility Program

I've created this hip flexibility program for those that would like to improve their flexibility in an efficient manner, with a follow along video that only … [Read More]

Shoulder & Upper Back Flexibility Program

For anyone who wants better shoulder health, shoulder flexibility, a looser upper back and improved posture, this program takes all the guess work out of it to … [Read More]

Antranik’s Rings Bodyweight Training Routine

This is for anybody who wants to get strong and have fun with a gymnastics-inspired routine. It is highly bodyweight-exercise oriented (no external weights) and … [Read More]

Antranik’s Easy Hamstrings Program

For those who have poor flexibility, tight hamstrings and want a simple program that will help them to get looser in a gentle, non-painful manner. In this … [Read More]

Front Splits Fast Program

This program will help you achieve the front splits in such a simple and straightforward manner that you will be blown away! You will find great elegance in its … [Read More]

Contact · Login

Start Training Smarter.

Join my newsletter and you'll get my strength training guide for free, exclusive discounts, and my latest insights!

Invalid email address
I promise not to spam you. You can unsubscribe at any time.
Thanks for subscribing! Please check your email for the special offer.