Laboratory Testing in Urgent Care: Best Practices for Choosing and Interpreting Respiratory and Genitourinary Tests (ObGyn CME and Infectious Disease CME)

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Delivery Method:	Online
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Publication Date: November 2025 (Volume 4, Number 11)

CME Credits: 4 AMA PRA Category 1 Credits™, 4 ACEP Category I credits, 4 AAFP Prescribed credits, and 4 AOA Category 2-B CME credits. CME expires 11/01/2028.

Specialty CME Credits: Included as part of the 4 credits, this CME activity is eligible for 2 ObGyn and 2 Infectious Disease CME credits, subject to your state and institutional approval.

Authors

Peer Reviewers

Abstract

Patients presenting to urgent care settings expect prompt diagnosis, treatment, and resolution of their symptoms. In order to provide high-quality, evidence-based care, urgent care clinicians must be familiar with currently available diagnostic tests and understand when to order or withhold those tests. This issue reviews diagnostic approaches used to evaluate respiratory and genitourinary complaints, including available testing modalities, their clinical utility and limitations, and practical recommendations for management. Key clinical pearls and common pitfalls are highlighted to support efficient, accurate diagnosis, and appropriate treatment decisions.

Case Presentations

A 15-year-old boy presents to the urgent care with a sore throat, fever, nasal congestion, cough, and fatigue for 2 days…

• The physical examination is significant for tonsillar exudates and bilateral tender anterior cervical lymph nodes.
• An in-office rapid strep antigen test is negative.
• The patient’s mother asks you to prescribe an antibiotic for “strep throat.”
• Are empiric antibiotics the appropriate management choice for this patient? Is additional testing needed and if so, which tests?

A 25-year-old woman presents to the urgent care complaining of urinary frequency and urgency...

• She states that she is certain this is "another UTI" and requests antibiotics.
• A review of her chart indicates that she has had 4 previous visits to urgent care in the past 6 months, with no growth indicated on urine culture at 2 of those visits.
• She reports that she is sexually active with her partner of 6 months. She says it is a monogamous relationship but notes that the urinary tract infections seemed to start around the same time she became sexually active with this partner.
• She has been taking over-the-counter phenazopyridine for symptom relief.
• A urine pregnancy test is negative. The patient declined a pelvic examination because she is convinced this is a urinary tract infection.
• Is a urinalysis helpful in the initial diagnostic workup for this patient? Is a urine culture needed? Is any additional testing indicated?

A 25-year-old woman calls your urgent care clinic asking to review her lab results…

• She presented to your clinic 2 days ago for vaginal discharge. The clinician who saw her had the patient self-swab for a molecular vaginitis and STI panels.
• Her results are negative for chlamydia, gonorrhea, Trichomonas, Atopobium, Megasphaera, bacterial vaginosis-associated bacteria, and Candida glabrata and Candida krusei. She has low positive results for Gardnerella vaginalis, Candida albicans, and Ureaplasma hominis.
• Should you treat for Gardnerella, Candida, and Ureaplasma? How do you distinguish normal flora from pathogen? Do the patient’s history or physical examination alter your treatment plan?

A 30-year-old man presents to the urgent care with concern that he has pneumonia…

• He states that his 5-year-old son was seen by the pediatrician yesterday and diagnosed with “walking pneumonia.” He requests a "pneumonia test” for himself.
• He reports a runny nose, low-grade fever, chest congestion, and cough for the past 2 days.
• He does not appear to be in any acute distress, and there are no adventitious lung sounds.
• What test(s) for atypical pneumonia, if any, should be performed? Are empiric antibiotics without testing appropriate?

Accreditation:

EB Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.