USMLE Forum Archives - USMLE Step 3 - Which of the following is most appropria
Which of the following is most appropria
meduploader - 05-07-09 14:25
A 78-year-old woman is being discharged from a rehabilitation center to home care following treatment for a vertebral compression fracture. She did well during therapy and has never required bladder catheterization. At the time of discharge, she is asymptomatic, her vital signs are normal, and she is able to handle most activities of daily living. However, a pre-discharge routine urine culture grows greater than 105 colony-forming units/mL of Escherichia coli resistant to ampicillin, trimethoprim–sulfamethoxazole, and ciprofloxacin.
Which of the following is most appropriate at this time?
meduploader - 05-07-09 14:25
A 78-year-old woman is being discharged from a rehabilitation center to home care following treatment for a vertebral compression fracture. She did well during therapy and has never required bladder catheterization. At the time of discharge, she is asymptomatic, her vital signs are normal, and she is able to handle most activities of daily living. However, a pre-discharge routine urine culture grows greater than 105 colony-forming units/mL of Escherichia coli resistant to ampicillin, trimethoprim–sulfamethoxazole, and ciprofloxacin.
Which of the following is most appropriate at this time?
The correct answer and explanation will be available after you answer.
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#2
Re: Which of the following is most appro zkadhem - 05-07-09 22:37 My answer is: e.
This asymptomatic bacteruria
#14
Re: Which of the following is most appro conym5 - 04-14-10 13:41 A CT scan of the kidneys may show areas of infection, but this study is unlikely to be helpful for this patient. In addition, the risk of intravenous contrast is unacceptable in a marginal clinical setting such as this.
#20
Re: Which of the following is most appro babbu5508 - 08-30-10 03:35 My answer is: b.
b. A 7-day course of oral moxifloxacin.. a pre-discharge routine urine culture grows greater than 105 colony-forming units/mL of Escherichia coli resistant to ampicillin, trimethoprim–sulfamethoxazole, and ciprofloxacin.
#22
Re: Which of the following is most appro zampaoverture - 08-30-10 18:13 
posted by zampaoverture on 08-30-10 18:00
[ANSWER e]
[ANSWER e]
This question is erroneous on two levels:
1-The author states that “Although treating elderly women or women with diabetes mellitus is tempting, studies have found that such therapy is no better than watchful waiting.” Yet the author still wants to give this patient 3 days course of IV gentamicin.
2-Choice E: The correct response in my opinion, does not contradict any treatment option (if necessary), as it is correct that “No additional treatment or diagnostic studies”
#23
Re: Which of the following is most appro zampaoverture - 08-30-10 18:15 posted by meduploader on 05-07-09 14:25
A 78-year-old woman is being discharged from a rehabilitation center to home care following treatment for a vertebral compression fracture. She did well during therapy and has never required bladder catheterization. At the time of discharge, she is asymptomatic, her vital signs are normal, and she is able to handle most activities of daily living. However, a pre-discharge routine urine culture grows greater than 105 colony-forming units/mL of Escherichia coli resistant to ampicillin, trimethoprim–sulfamethoxazole, and ciprofloxacin.
Which of the following is most appropriate at this time?
A 78-year-old woman is being discharged from a rehabilitation center to home care following treatment for a vertebral compression fracture. She did well during therapy and has never required bladder catheterization. At the time of discharge, she is asymptomatic, her vital signs are normal, and she is able to handle most activities of daily living. However, a pre-discharge routine urine culture grows greater than 105 colony-forming units/mL of Escherichia coli resistant to ampicillin, trimethoprim–sulfamethoxazole, and ciprofloxacin.
Which of the following is most appropriate at this time?
This question is erroneous on two levels:
1- The author states that (Although treating elderly women or women with diabetes mellitus is tempting, studies have found that such therapy is no better than watchful waiting. In this patient, treatment is more difficult than usual because of the relative resistance of the Escherichia coli to various antibiotic agents.) Yet the author still wants to give this patient 3 days course of gentamicin.
2-Choice E: The correct response in my opinion, does not contradict any treatment option (if necessary), as it is correct that (No additional treatment or diagnostic studies)
#24
Re: Which of the following is most appro babbu5508 - 08-30-10 23:50 posted by zampaoverture on 08-30-10 18:15
This question is erroneous on two levels:
1- The author states that (Although treating elderly women or women with diabetes mellitus is tempting, studies have found that such therapy is no better than watchful waiting. In this patient, treatment is more difficult than usual because of the relative resistance of the Escherichia coli to various antibiotic agents.) Yet the author still wants to give this patient 3 days course of gentamicin.
2-Choice E: The correct response in my opinion, does not contradict any treatment option (if necessary), as it is correct that (No additional treatment or diagnostic studies)
This question is erroneous on two levels:
1- The author states that (Although treating elderly women or women with diabetes mellitus is tempting, studies have found that such therapy is no better than watchful waiting. In this patient, treatment is more difficult than usual because of the relative resistance of the Escherichia coli to various antibiotic agents.) Yet the author still wants to give this patient 3 days course of gentamicin.
2-Choice E: The correct response in my opinion, does not contradict any treatment option (if necessary), as it is correct that (No additional treatment or diagnostic studies)
seems quite true...but asymptomatic bacteriuria should always be treated as far as i believe according to usmle...........
#30
Re: Which of the following is most appro babbu5508 - 02-22-11 10:34 women with asymptomatic bacteriuria, such as pregnant patients and renal transplant recipients require treatment. A 3-day course of intravenous gentamicin
#31
Re: Which of the following is most appro sudha2015 - 03-31-11 12:12 My answer is: b.
a pre-discharge routine urine culture grows greater than 105 colony-forming units/mL of Escherichia coli resistant to ampicillin, trimethoprim–sulfamethoxazole, and ciprofloxacin.
#32
Re: Which of the following is most appro babbu5508 - 03-31-11 12:47 Certain people are at a higher risk for kidney infections if they develop asymptomatic bacteriuria. The following increases risk:
Diabetes
Infected kidney stones
Kidney transplant
Older age
Pregnancy -- up to 40% of pregnant women with untreated asymptomatic bacteriuria will develop a kidney infection
Vesicoureteral reflux in young children
#39
Re: Which of the following is most appro mockingbird - 06-30-11 01:13 My answer is: a.
We still need to treat asymptomatic UTI.
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