Repeated USMLE Questions Step 2 CK- 321

A 24 -year-old woman presents to the clinic with a 3-day history of burning micturition, frequency and suprapubic pain. She has no fever, nausea or vomiting. Examination reveals mild tenderness on the suprapubic area. There is no costovertebral angle tenderness. Urinalysis shows 20 leukocytes with no casts.

What is the next appropriate step of management?

A-Trimethoprim-sulfamethoxazole for 3 days

B-Penicillin and gentamicin for 7 days

C-Intravenous pyelography

D-CT scan of the pelvis

E-No treatment necessary and follow up in 3 days

Answer:






This is a case of acute lower urinary tract infection with typical symptoms of dysuria, frequency and suprapubic pain. TMX is the treatment of choice of this condition. There is no evidence for acute pyelonephritis. There is no need for further investigations as most cases of UTI are diagnosed clinically. Treatment is necessary to avoid ascending renal infection.

The correct answer is A