[25F] With hematuria, cough, and breathing difficulties

Patient Description

A 25-year-old female reports bright red blood in urine and when wiping for one day. Symptoms include a cough for three days, headaches, and sinus symptoms for two days, along with moderate breathing difficulties. The patient is on birth control (norethindrone) and not experiencing menstruation. She has a history of a bulging disc causing moderate to severe back pain. Urinary symptoms include increased frequency, urgency, and unusual odor, without pain or burning sensation. No fever or chills reported. Past medical history includes a disconnected aortic arch and two holes in the heart, with subclavian bypass surgeries in December 2021 and December 2022. Allergies include oxycodone and hydrocodone. Current medications: norethindrone, montelukast, pregabalin (150 mg twice daily), baclofen, vilazodone, celecoxib, and loratadine, taken twice daily.

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Arora's Assessment

What might be happening

Based on your symptoms and medical history, here are some possibilities:

  1. Urinary Tract Infection (UTI):

    • Blood in urine, increased frequency, urgency, and unusual odor could indicate a UTI. UTIs are common and can cause these symptoms. A urine test can confirm this, and antibiotics are typically prescribed.
  2. Kidney Stones:

    • Bright red blood in urine can also be a sign of kidney stones. These can cause pain and blood in the urine. Imaging tests like an ultrasound or CT scan can help diagnose this.
  3. Respiratory Infection:

    • Your cough, headache, and sinus symptoms might suggest a respiratory infection, such as a cold or sinusitis. These are usually viral and resolve on their own, but bacterial infections may require antibiotics.
  4. Medication Side Effects:

    • Some medications can cause urinary symptoms or respiratory issues. It's important to review these with your doctor.

What you can do

For Blood in Urine:

  • See a Doctor: It's important to see a healthcare provider to rule out serious conditions like kidney stones or infections.
  • Stay Hydrated: Drink plenty of water to help flush out your urinary system.

For Respiratory Symptoms:

  • Rest and Hydration: Ensure you get plenty of rest and stay hydrated.
  • Over-the-Counter Relief: Consider using decongestants or saline nasal sprays for sinus relief.

For Back Pain:

  • Pain Management: Continue with prescribed medications and consider physical therapy exercises if recommended by your doctor.

General Advice:

  • Monitor Symptoms: Keep track of any changes or worsening of symptoms.
  • Use MDandMe: Journal your symptoms and track progress to share with your healthcare provider.

What you should look out for

  • Seek Immediate Care If:
    • You experience severe pain, fever, or chills.
    • You have difficulty breathing that worsens.
    • You notice any new or worsening symptoms.

Remember, it's important to consult with a healthcare professional for a formal diagnosis and treatment plan.

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6 mo ago

People Also Ask


What could cause bright red blood in urine without pain?

Bright red blood in urine without pain can be caused by a urinary tract infection, kidney stones, or other conditions affecting the urinary tract. It's important to consult a healthcare provider for proper diagnosis.


How can I differentiate between a urinary tract infection and kidney stones?

A urinary tract infection often presents with symptoms like increased frequency, urgency, and sometimes pain during urination, while kidney stones may cause severe pain in the back or side, nausea, and blood in the urine. Imaging tests can help differentiate between the two.


What are common side effects of norethindrone and other medications I am taking?

Norethindrone can cause side effects such as changes in menstrual flow, headaches, and nausea. Other medications like pregabalin and celecoxib can cause dizziness, drowsiness, or gastrointestinal issues. It's important to discuss any concerns with your doctor.


When should I seek medical attention for respiratory symptoms?

You should seek medical attention for respiratory symptoms if you experience severe difficulty breathing, high fever, or if symptoms persist or worsen over time. Immediate care is necessary if breathing difficulties become severe.


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