[21F] Experiencing late period, sharp lower back and abdominal pain, nausea, and weakness

Patient Description

A 21-year-old female presents with a 20-day late menstrual period, sharp lower back pain that intensifies with walking, and sharp, crampy lower abdominal pain that lessens when lying down. The patient rates the abdominal pain as 7 out of 10 in severity and describes feeling weak and shaky, though still able to perform daily activities. Nausea occurs with movement or when getting up from a lying position, and the patient also reports experiencing chills. Pregnancy tests have been negative despite unprotected sexual intercourse since the last period. No urinary changes, vaginal bleeding, dizziness, or light-headedness were reported. The patient has no known drug allergies, no other medications, and no significant past medical history.

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Arora's Assessment

What might be happening

Based on the information you've provided, potential diagnoses include:

  • Kidney Stones: These are hard deposits made of minerals and salts that form inside your kidneys. They can cause severe pain in your back or side, along with other symptoms such as nausea and chills.

    • Treatment often involves pain relief and drinking lots of water to help pass the stone. In some cases, medical procedures may be needed to remove or break up larger stones.
  • Urinary Tract Infection (UTI): This is an infection in any part of your urinary system, which includes your kidneys, bladder, ureters, and urethra. UTIs can cause lower abdominal pain and back pain, along with other symptoms such as a frequent urge to urinate and a burning sensation when urinating.

    • Treatment typically involves antibiotics to kill the bacteria causing the infection.
  • Pregnancy: Even though your pregnancy tests have been negative, it's still possible that you could be pregnant, especially if your period is late and you've had unprotected sex. Early pregnancy can cause a variety of symptoms, including lower back pain, abdominal pain, nausea, and fatigue.

    • If you're pregnant, you'll need to start prenatal care. If you're not ready to be a parent, there are other options available to you, such as adoption and abortion.

What you can do

You should see a doctor as soon as possible to get a proper diagnosis. In the meantime, here are some things you can do to help manage your symptoms:

  1. Stay Hydrated: Drinking plenty of water can help flush out your urinary system and may help if you have kidney stones or a UTI.

  2. Rest: If you're feeling weak and shaky, make sure to get plenty of rest. Try to avoid activities that make your symptoms worse.

  3. Pain Relief: Over-the-counter pain relievers, such as ibuprofen, can help manage your back and abdominal pain. However, you should check with a healthcare professional before starting any new medication.

What you should look out for

You should seek immediate medical attention if you experience any of the following:

  • Severe pain that you can't manage with over-the-counter pain relievers
  • Fever or chills
  • Blood in your urine
  • Vomiting or severe nausea
  • Any other symptoms that are severe or concerning to you

Please remember that this advice is intended to be general in nature, and specific causes may not apply to your personal circumstances. Always consult with a healthcare provider for appropriate examination, testing, and care recommendations.

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10 mo ago

People Also Ask


What are the common symptoms of kidney stones?

Common symptoms of kidney stones include severe pain in the back or side, pain that radiates to the lower abdomen and groin, nausea, vomiting, and chills. Some people may also experience blood in the urine or frequent urination.


Can a urinary tract infection cause back pain?

Yes, a urinary tract infection can cause back pain, especially if the infection has spread to the kidneys. Other symptoms of a UTI may include a frequent urge to urinate, a burning sensation when urinating, and cloudy or strong-smelling urine.


Is it possible to be pregnant even if the pregnancy test is negative?

Yes, it is possible to be pregnant even if the pregnancy test is negative, especially if the test was taken too early or not according to instructions. If your period is late and you've had unprotected sex, it's advisable to repeat the test after a few days or consult a healthcare provider for further evaluation.


What should I do if I experience severe abdominal pain and chills?

If you experience severe abdominal pain and chills, it's important to seek immediate medical attention. These symptoms could indicate a serious condition that requires prompt treatment, such as a kidney stone, infection, or other medical issues.


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