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Author Question: A 20-year-old female patient has suprapubic discomfort, pyuria, dysuria, and bacteriuria greater ... (Read 77 times)

jhjkgdfhk

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on: Jul 23, 2018
A 20-year-old female patient has suprapubic discomfort, pyuria, dysuria, and bacteriuria greater than 100,000/mL of urine. Which are the most likely diagnosis and treatment?
 
  a. Uncomplicated lower urinary tract infection treatable with short-course therapy
  b. Complicated lower urinary tract infection treatable with single-dose therapy
  c. Uncomplicated upper urinary tract infection requiring 14 days of oral antibiotics
  d. Complicated upper urinary tract infection requiring parenteral antibiotics

Question 2

A young, nonpregnant female patient with a history of a previous urinary tract infection is experiencing dysuria, urinary urgency and frequency, and suprapubic pain of 3 days' duration. She is afebrile.
 
  A urine culture is positive for more than 100,000/mL of urine. The nurse caring for this patient knows that which treatment is most effective?
  a. A 14-day course of amoxicillin with clavulanic acid (Augmentin)
  b. A 7-day course of ciprofloxacin (Cipro)
  c. A single dose of fosfomycin (Monural)
  d. A 3-day course of trimethoprim/sulfamethoxazole (Bactrim)


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ladyjames123

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Reply #1 on: Jul 23, 2018
Answer to Question 1

ANS: A
These are symptoms of uncomplicated cystitis, which is a lower urinary tract infection that can be treated with a short course of antibiotics. Short-course therapy is more effective than single-dose therapy and is preferred. A complicated lower urinary tract infection would be associated with some predisposing factor, such as renal calculi, an obstruction to the flow of urine, or an indwelling catheter. Upper urinary tract infections often include severe flank pain, fever, and chills.

Answer to Question 2

ANS: D
Short-course therapy is recommended for uncomplicated, community-acquired lower urinary tract infections. The short course is more effective than a single dose, and compared with longer course therapies, it is less costly, has fewer side effects, and is more likely to foster compliance. Amoxicillin with clavulanic acid is a second-line drug used for pyelonephritis. Fosfomycin is a second-line drug and can be useful in patients with drug allergies.


jhjkgdfhk

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Reply #2 on: Jul 23, 2018
Thank you!


ladyjames123

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Reply #3 on: Jul 23, 2018
Always glad to help...


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