A 32-year-old woman is evaluated for a 2-day history of fever, urinary frequency, left sided flank pain, and nausea without vomiting. She also has diet-controlled type 2 DM. On examination, temperature is 38.3°C, blood pressure is 122/82 mmHg, pulse rate is 102/min, and respiration rate is 18/min. Left- sided costovertebral angle tenderness is present. Results of abdominal and pelvic examinations are normal. Leukocyte count: 14,000/4 (14 x 109/L) Creatinine: 1.1 mg/dl (97.2 umol/L) Urinalysis: positive for leukocyte esterase and nitrites. Urine culture: pending. Pregnancy test: negative. Which of the following is the most appropriate treatment?
سؤال مجاني 4 من 10 اليوم · اشترك وكمّل بدون حد
اعرض الإجابة
الإجابة والشرح
ادخل لحسابك عشان نحفظ إجاباتك ونوريك أخطاءك.
الإجابة: B. Ciprofloxacin.
Fever, flank pain, CVA tenderness and leukocytosis in a diabetic woman = acute pyelonephritis (complicated UTI). Complicated UTI is treated with a fluoroquinolone (ciprofloxacin). Nitrofurantoin (and TMP-SMX short course) are listed for uncomplicated cystitis only; nitrofurantoin does not reach adequate renal tissue levels. Ampicillin is not a listed empiric UTI agent.
ليش كل خيار صح أو غلط
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B
ليش صح
Fever, flank pain and CVA tenderness in a diabetic woman point to acute pyelonephritis, not simple cystitis. Oral ciprofloxacin is a listed empiric choice for acute UTI (E. coli).
✓ Inefctious Diseases 🦠.pdf · p. 6 -
C
ليش غلط
Nitrofurantoin is listed for acute uncomplicated cystitis (and UTI prophylaxis), not for pyelonephritis with fever and flank pain.
✓ view-material.pdf · p. 189 -
D
ليش غلط
The 3-day TMP-SMX course is listed for uncomplicated cystitis and only if local resistance is below 20%. This is pyelonephritis in a diabetic with fever and flank pain.
✓ view-material.pdf · p. 189
- المصدر
- view-material.pdf · p. 189
Antibiotic-1 (3).pdf · p. 36 - المحاضرة
- Antimicrobials · Infectious Diseases · Module B
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