#april2020mccqe1
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 diabetes mellitus.
On physical examination, temperature is 38.3°C (100.9°F), blood pressure is 122/82 mm Hg, 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/μL (14 × 109/L)
Creatinine : 1.1 mg/dL (97.2 μmol/L)
Urinalysis : Positive for leukocyte esterase and nitrites
Pregnancy test : Negative
Urine culture : Pending
Which of the following is the most appropriate treatment?
(A) Ampicillin
(B) Ciprofloxacin
(C) Nitrofurantoin
(D) Trimethoprim-sulfamethoxazole
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 diabetes mellitus.
On physical examination, temperature is 38.3°C (100.9°F), blood pressure is 122/82 mm Hg, 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/μL (14 × 109/L)
Creatinine : 1.1 mg/dL (97.2 μmol/L)
Urinalysis : Positive for leukocyte esterase and nitrites
Pregnancy test : Negative
Urine culture : Pending
Which of the following is the most appropriate treatment?
(A) Ampicillin
(B) Ciprofloxacin
(C) Nitrofurantoin
(D) Trimethoprim-sulfamethoxazole