HY USMLE Q #1179 – Renal

A 30-year-old woman comes to emergency for a 1-day history of fever, chills, and left flank pain. She has type II diabetes mellitus. Physical examination shows left costovertebral angle tenderness. Temperature is 103 F. Blood pressure is 120/80. Leukocytes are 23,000/μL. She is treated inpatient with daily IV ceftriaxone. At day 7, she remains febrile. Which of the following is the next best step in management?

  Continue current management
  CT of the abdomen with contrast
  Discontinue ceftriaxone and initiate ampicillin and gentamicin
  Discontinue ceftriaxone and initiate ciprofloxacin
  Ultrasound

Leave a Reply

Your email address will not be published. Required fields are marked *