WBR1056
| Author | [[PageAuthor::Abdurahman Khalil, M.D. [1]]] |
|---|---|
| Exam Type | ExamType::USMLE Step 2 CK |
| Main Category | MainCategory::Internal medicine, MainCategory::OB/GYN |
| Sub Category | SubCategory::Genitourinary, SubCategory::Infectious Disease |
| Prompt | [[Prompt::A 32 year old woman G1P1 comes to the clinic complaining of urgency, frequency and burning during urination for the last 4 days. She never had this problem before. She denies any fever, night sweating or pain. Her past medical history unremarkable except for caesarian section 3 years ago. She doesn’t smoke, drinks alcohol occasionally and sexually active with her husband, her vitals are Temperature: 37, 1 , heart rate: 78 , respiration: 17, blood pressure: 134/67. The physical examination is normal except for mild tenderness over the pubic area. Tapping on Costco vertebral angel doesn’t show any tenderness. No
vaginal discharge. What’s the preferred treatment for this patient?]] |
| Answer A | AnswerA::Nitrofurantoin |
| Answer A Explanation | AnswerAExp::Correct, nitrofurantoin is the preferred antibacterial to treat acute cystitis. |
| Answer B | AnswerB::Ciprofloxacin |
| Answer B Explanation | AnswerBExp::Incorrect. Broad spectrum antibiotics are reserved for intolerance or failure of first line antibacterials. |
| Answer C | AnswerC::Ceftriaxone |
| Answer C Explanation | AnswerCExp::Incorrect. Beta-lactams is not recommended because of the increasing resistance, in addition to their adverse effects and poor efficacy. |
| Answer D | AnswerD::Doxycycline |
| Answer D Explanation | AnswerDExp::Incorrect. Doxycycline is used to treat chlamydiae, but is not as effective to treat e.coli which is the most common cause of simple cystitis. |
| Answer E | AnswerE::Erythromycin |
| Answer E Explanation | AnswerEExp::Incorrect. not effective to treat acute cystitis. |
| Right Answer | RightAnswer::A |
| Explanation | [[Explanation:: Educational Objective: |
| Approved | Approved::No |
| Keyword | WBRKeyword::Cystitis, WBRKeyword::E.coli, WBRKeyword::Antibiotic resistance |
| Linked Question | Linked:: |
| Order in Linked Questions | LinkedOrder:: |
- ↑ Gupta K, Hooton TM, Naber KG, Wullt B, Colgan R, Miller LG; et al. (2011). "International clinical practice guidelines for the treatment of acute uncomplicated cystitis and pyelonephritis in women: A 2010 update by the Infectious Diseases Society of America and the European Society for Microbiology and Infectious Diseases". Clin Infect Dis. 52 (5): e103–20. doi:10.1093/cid/ciq257. PMID 21292654.