Medical Question of the Day- 22

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A 68 year-old woman complains of fever, anorexia and right flank pain for 2 days. She vomited twice today. On physical examination, her temperature is 101.3 F and there is moderate tenderness on the right costovertebral angle. Her urinalysis shows leukocytes and pus cells.

What is the most appropriate next step of management?

A – Hospitalization and intravenous antibiotics

B – Outpatient wide spectrum antibiotics and schedule a visit after 3 days

C – Collect blood and urine samples for culture

D – Schedule MRI of the abdomen and pelvis

E – Schedule Intravenous pyelogram

Answer




Rule of thumb: any case of pyelonephritis, endocarditis or any expected sepsis, collect blood and urine samples for culture before administration of antibiotics. Very important repeated topic in all steps of USMLE. Collect for culture first….please don’t forget that…..MRI and IVP could be done later if the case is complicated but history, examination and urinalysis are enough for diagnosis of most cases of acute pyelonephritis.

The correct answer is C

We got 11 Correct answers. Drawing is done and the winner is Huss

Congratulations and better luck for all of you on next question







51 thoughts on “Medical Question of the Day- 22”

  2. Thank you Kien

  3. Thank you Ghazal

  4. Thank you Prudence

  5. Thank you Ebenezer

  8. The correct answer is C. Since urinalysis showed positive for leukocytes and pus cells, the next step will be to take blood and urine samples for culture so as to the narrow the particular bacterial and thus perform appropriate antibiotics susceptibility testing to avoid resistance.

  9. The correct answer is C. Since urinalysis showed positive for leukocytes and pus cells, the next step will be to take blood and urine samples for culture so as to the narrow the particular bacterial and thus perform appropriate antibiotics susceptibility testing to avoid resistance.

  10. The correct answer is C. Since urinalysis showed positive for leukocytes and pus cells, the next step will be to take blood and urine samples for culture so as to the narrow the particular bacterial and thus perform appropriate antibiotics susceptibility testing using to avoid resistance.

  11. Option C is right

  12. Thank you Huss

  13. Thank you Erhabor

  14. Thank you Salifu

  16. Answer is A

  18. Thank you Phineas

  19. Thank you Lakshmanan

  20. Thank you Unni

  21. Thank you Ebin

  22. Thank you Eby

  23. Thank you Michael

  24. Thank you Sayed

  25. Thank you Girish

  26. Thank you Anil

  27. Thank you Dr Sabbir

  28. Thank you Najm

  29. Thank you Juma

  30. Thank you Tariqul

  31. Thank you Mohammad

  32. Thank you Mohamed

  33. Thank you Chong

  34. Thank you Rabina

  35. D

  36. The correct answer is C

  37. E is the answer

  38. Ans is A

  39. Answer is D

  41. Answer is option A

  42. A

  43. collect urine sample and blood for culture followed by hospitalization and iv antibiotics

  44. C

  45. C.

  46. A

  47. Collect blood and urine sample for culture

  48. A

  50. A

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