What would the most appropriate therapy be? A 20 year old female - ProProfs Discuss
Topics
Products
Follow Us:

What would the most appropriate therapy be? A 20-year-old female presents with a two-day history of dysuria and increased urinary frequency. She states that she was recently married and was not sexually active prior to the marriage. Physical exam reveals a temperature of 100.7 °F with normal vital signs. Gynecological exam reveals no evidence of discharge, vaginitis, or cervicitis. Urinalysis reveals 14 white blood cells per high-powered field with many gram-negative rods.



A. Ampicillin
B. Ceftriaxone
C. Fluconazole
D. Gentamicin
E. Metronidazole

This question is part of

USMLE microbiology prt 2
Asked by Andrew, Last updated: Mar 27, 2020

+ Answer
Request

2 Answers

Asante

Asante

Answered Apr 16, 2019

The correct answer is A Ampicillin

 

John Smith

John Smith

Answered Sep 09, 2016

Ampicillin-the correct answer is a. the patients presentation is consistent with a simple urinary tract infection; there is a short history of dysuria, increased urinary frequency and the appearance of white blood cells and gram-negative rods in the urine. urinary tract infections are common in women after they become sexually active. the infection is likely caused by urethral trauma during intercourse, which leads to bacterial contamination of the bladder. since the majority of these infections are caused by escherichia coli (a gram-negative rod), the most appropriate therapy would be ampicillin for around 10 days. ceftriaxone (choice b) is the treatment of choice for uncomplicated infections with n. gonorrhoeae, now that most strains are resistant to penicillin. intravenous ceftriaxone is a regimen reserved for the treatment of life-threatening infections. fluconazole (choice c) is indicated for the treatment of vaginal candidiasis. since there is no vaginal discharge and the patient has gram-negative rods in the urine, a diagnosis of vaginal candidiasis can be excluded. gentamicin (choice d) would be an inappropriate choice since the majority of urinary tract infections caused by gram negative rods are sensitive to ampicillin and the potential for toxicity secondary to gentamicin is great. metronidazole (choice e) is an antibiotic typically used in the treatment of trichomoniasis, giardiasis, and gardnerella, as well as serious infections believed to be caused by anaerobic bacteria. since there is no vaginal discharge and the patient has gram negative rods in the urine, one can conclude that these infections are not present and the patient instead has a urinary tract infection.
 

Search for Google images
Select a recommended image
Upload from your computer
Search for Google images
Select a recommended image
Upload from your computer
Search for Google images
Select a recommended image
Upload from your computer

Email Sent
We have sent an email to your address "" with instructions to reset your password.