70-year-old male patient with a 4-week history of intermittent fever and night sweating complained of flank pain, his GP ordered urine and blood culture (negative), he started antibiotics but there was no effect, examination unremarkable, and his urine analysis showed microcytic haematuria +++, what is the next step?
سؤال مجاني 1 من 10 اليوم · اشترك وكمّل بدون حد
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الإجابة والشرح
ادخل لحسابك عشان نحفظ إجاباتك ونوريك أخطاءك.
الإجابة: B. CT Abdomen and Pelvis
An elderly man with prolonged fever, night sweats, flank pain and haematuria with negative cultures and no response to antibiotics should raise suspicion of renal cell carcinoma, a recognised malignant cause of PUO (classic triad: haematuria, flank pain, flank mass). The next step is cross-sectional imaging – CT abdomen and pelvis – which is part of the PUO work-up. Repeat cultures add little after negative cultures and failed antibiotics; LP and echo are not directed by the findings.
ليش كل خيار صح أو غلط
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A
ليش غلط
Blood cultures are already part of the first-line PUO tests and were negative. When those give no answer, the next tier is abdominal and chest CT, not more cultures.
✓ Inefctious Diseases 🦠.pdf · p. 16 -
B
ليش صح
His fever remains unexplained after negative cultures, and the PUO work-up includes a CT scan of the chest and abdomen. His flank pain and hematuria point to the abdomen, which this scan covers.
✓ Pyrexia of unknown origin (PUO).pdf · p. 4 -
C
ليش غلط
Lumbar puncture is for CNS symptoms or signs; this man has flank pain and hematuria and an unremarkable examination.
✓ Pyrexia of unknown origin (PUO).pdf · p. 4 -
D
ليش غلط
Echocardiography is for suspected endocarditis; nothing here (examination unremarkable) points to the heart, while flank pain and hematuria point to the kidney.
✓ Inefctious Diseases 🦠.pdf · p. 14
- المصدر
- Pyrexia of unknown origin (PUO).pdf · p. 3
Nephrology 🌷.pdf · p. 6
Pyrexia of unknown origin (PUO).pdf · p. 4 - المحاضرة
- Pyrexia of Unknown Origin · Infectious Diseases · Module B
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- ID bank