Posted by KING from IP 76.18.19.70 on November 30, 2006 at 19:42:34:
A 30-year-old Caucasian elementary school teacher who is 34 weeks pregnant with her first child comes to the clinic complaining that "it burns when I urinate." She has also noticed some suprapubic pain and increased urinary frequency and urgency. Her symptoms began two days ago and are causing her extreme discomfort at work. Prior to this, her pregnancy had been uncomplicated. Her temperature is 36.7C (98F), blood pressure is 126/78 mm Hg, pulse is 76/min, and respirations are 15/min. On physical examination, chest is clear to auscultation and heart sounds are normal. There is no evidence of hepatosplenomegaly or costovertebral tenderness. Bowel sounds are normal. Suprapubic tenderness is elicited with deep palpation. Laboratory evaluation reveals the following:
Urinalysis
Color Yellow
Turbidity Cloudy
pH 6.7
Specific gravity 1.020
Protein 1+
Glucose Negative
Ketone Negative
Bile Negative
Hemoglobin Negative
Leukocyte esterase Positive
Nitrite Positive
Urobilinogen < 1 EU/dL
WBC 40+/HPF
RBC 2/HPF
Bacteria Many
Item 1of 2
What is the most appropriate medication to prescribe for her condition?
A) Cephalexin
B) Ciprofloxacin
C) Clindamycin
D) Tetracycline
E) Trimethoprim-sulfamethoxazole