Thursday, April 3, 2014

Question 36

36.  Your patient is a 46 year old diabetic female that presents with a fever, flank pain, dysuria, polyuria, nausea and vomiting. Her vitals are as follows Temp 102 F, HR 121, RR 20, BP 120/80.  Her CBC reveals of WBC 14.7, Hgb 15, Hct 44.3.  Her BMP is normal. Her urine reveals WBC > 200, many bacteria and is nitrite positive.  Which of the following is the best management plan.

A.  Give the patient Rocephin 1 gram IV Piggy Back and discharge the patient home on Bactrim for 14 days
B.  Discharge the patient home on Cipro 500 mg BID for 7 days
C.  Give the patient  Rocephin 1 gram IV Piggy Back and admit the patient to the hospital.
D.  Discharge the patient home on Bactrim DS one PO BID for 7 days.

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