#july2020mccqe1
A 77-year-old woman is evaluated during a routine physical examination. She is asymptomatic and has a history of hypertension, type 2 diabetes mellitus, and
hyperlipidemia. Medications are aspirin, lisinopril, hydrochlorothiazide, a glyburide, and lovastatin. She has no allergies.
Her physical examination is unremarkable. Laboratory studies including serum creatinine, blood urea nitrogen, electrolytes, liver function tests, and a fasting lipid panel are normal. Her hemoglobin A1c is 6.3%.
Urinalysis shows 15 leukocytes per high-power field and bacteria; no erythrocytes, protein, or glucose are noted. Urine culture grows Escherichia coli of at least 105 colony- forming units (cfu)/mL.
Repeat urinalysis and urine culture confirm these results.
Which of the following is the most appropriate next step in management of this patient?
(A) Ciprofloxacin for 3 days
(B) Ciprofloxacin for 7 days
(C) Trimethoprim-sulfamethoxazole for 3 days
(D) No treatment
A 77-year-old woman is evaluated during a routine physical examination. She is asymptomatic and has a history of hypertension, type 2 diabetes mellitus, and
hyperlipidemia. Medications are aspirin, lisinopril, hydrochlorothiazide, a glyburide, and lovastatin. She has no allergies.
Her physical examination is unremarkable. Laboratory studies including serum creatinine, blood urea nitrogen, electrolytes, liver function tests, and a fasting lipid panel are normal. Her hemoglobin A1c is 6.3%.
Urinalysis shows 15 leukocytes per high-power field and bacteria; no erythrocytes, protein, or glucose are noted. Urine culture grows Escherichia coli of at least 105 colony- forming units (cfu)/mL.
Repeat urinalysis and urine culture confirm these results.
Which of the following is the most appropriate next step in management of this patient?
(A) Ciprofloxacin for 3 days
(B) Ciprofloxacin for 7 days
(C) Trimethoprim-sulfamethoxazole for 3 days
(D) No treatment