Question 1

An asymptomatic pregnant woman has a positive leukocyte esterase and positive nitrites on a urine dipstick screening. What will the provider do next?&#10;A) Admit to the hospital&#10;B) Obtain a urine culture&#10;C) Order a renal ultrasound&#10;D) Prescribe trimethoprim-sulfamethoxazole (TMP-SMZ)

Accepted Answer

A positive leukocyte esterase and positive nitrites on a urine dipstick screening suggest a urinary tract infection (UTI) may be present. A urine culture should be obtained to confirm the infection and identify the specific organism involved. Treatment can be initiated based on the results of the urine culture. Admission to the hospital, renal ultrasound, and prescribing TMP-SMZ may be indicated depending on the severity and complications of the UTI, but they are not the next steps in management.

Question 2

A 30-year-old male patient has a positive leukocyte esterase and nitrites on a random urine dipstick during a well patient exam. What type of urinary tract infection does this represent?&#10;A) Complicated&#10;B) Isolation&#10;C) Uncomplicated&#10;D) Unresolved

Accepted Answer

A

Question 3

An asymptomatic female is concerned about having come into contact with sexually transmitted gonorrhea and asks about antibiotics. What will the provider recommend?&#10;A) Amoxicillin-clavulanate for 10 days&#10;B) Cultures and treatment if symptoms appear&#10;C) Empirical ceftriaxone and azithromycin&#10;D) Trimethoprim-sulfamethoxazole

Accepted Answer

The most appropriate recommendation is to offer empirical therapy with ceftriaxone and azithromycin, as gonorrhea is a serious infection and can be asymptomatic. Cultures and treating only when symptoms appear is not the best choice, as it can lead to further spread of the infection. Amoxicillin-clavulanate and trimethoprim-sulfamethoxazole are not recommended treatments for gonorrhea.

Deck 135: Urinary Tract Infections and Sexually Transmitted Infections