View source for WBR1057

 {{WBRQuestion
|QuestionAuthor= {{AK}}
|ExamType=USMLE Step 2 CK
|MainCategory=Internal medicine
|SubCategory=Genitourinary, Infectious Disease
|MainCategory=Internal medicine
|SubCategory=Genitourinary, Infectious Disease
|MainCategory=Internal medicine
|SubCategory=Genitourinary, Infectious Disease
|MainCategory=Internal medicine
|MainCategory=Internal medicine
|MainCategory=Internal medicine
|SubCategory=Genitourinary, Infectious Disease
|MainCategory=Internal medicine
|SubCategory=Genitourinary, Infectious Disease
|MainCategory=Internal medicine
|SubCategory=Genitourinary, Infectious Disease
|MainCategory=Internal medicine
|SubCategory=Genitourinary, Infectious Disease
|MainCategory=Internal medicine
|SubCategory=Genitourinary, Infectious Disease
|MainCategory=Internal medicine
|MainCategory=Internal medicine
|SubCategory=Genitourinary, Infectious Disease
|Prompt=A 20 year old female college student comes to the Students health center complaining of urgency, frequency and itching for the last 3 days. She’s never had this problem before. She denies any fever, night sweating or pain. She smokes 2 pack/year, drinks 2 beers/day and she is sexually active with her new boyfriend and since then she started using oral contraceptives and her boyfriend uses condoms.  Vitals are Temperature: 37, 1 c, heart rate: 78 respiration: 17 blood pressure: 134/67. The physical examination is normal except for mild tenderness over the pubic area. Tapping on Costco vertebral angel doesn't show any tenderness. No vaginal discharge. 
From her medical history, which one of the following is likely to be related to her 
problem?
|Explanation=This patient has a typical history of acute uncomplicated cystitis. The strongest risk factor is sexual intercourse,which facilitates the entry of bacterial flora into the genitourinary mucosa.

Some preventive measures to reduce the risk of cystitis are :
* Cleaning genital areas prior to and after [[sexual intercourse]].
* For sexually active women, and to a lesser extent men, urinating within 15 minutes of sexual intercourse to allow the flow of urine to expel the bacteria before specialized extensions anchor the bacteria to the walls of the urethra.
* Having adequate fluid intake, especially water.
* Not resisting the urge to urinate.
* Taking showers, not baths, or urinating soon after taking a bath.
* Practicing good hygiene, including wiping from the front to the back to avoid contamination of the urinary tract by fecal pathogens.
|AnswerA=Alcohol
|AnswerAExp=Alcohol is not a risk factor for cystitis.
|AnswerB=Her age
|AnswerBExp=A young age doesn't propose a risk to cystitis.
|AnswerC=Using condom
|AnswerCExp=Using condoms reduces risk of UTIs and STDs
|AnswerD=The new relationship
|AnswerDExp=Sexual activity is the strongest risk factor for cystitis
|AnswerE=Using OCPs
|AnswerEExp=Incorrect
|EducationalObjectives=The strongest risk factor for cystitis is sexual intercourse.
|References=Hooton TM. Clinical practice. Uncomplicated urinary tract infection. N Engl J Med. 2012;366(11):1028-37.
|RightAnswer=D
|WBRKeyword=Cystitis, risk factor
|Approved=No
}}