b3 - miss_ismail_79

[ArchivalUser]

A previous: healthy =2yr old boy is brought the doc because of fever and abdominal pain for 24 hours. His development milestones are approp for age. He
is fully alert and responsive. His temperate is 38.6*C (101.5*F). blood pressure is 85|60 mm Hg. pulse is 100 and respirations are 20 F.xamin|on shows
suprapubic tenderness to deep palpn but no guarding or rebound. There are no palpable abdominal masses or costovertebral angle tenderness. The penis is
circumcised'. there is no urethral discharge. U/A shows 20-30 leukoc|hpf 5-6 eryth/hpf and nitrites. A urine culture grows 100.000 colonies/ml of
E Coli sensitive to all tested Ab Amoxicillin therapy is initiated 5 days later he is afebrile and asymptotic. UllrasonograpW ofthe kidneys shows no
abnormalides. which ofthe foll is the most approp next step in management
A) Discontinue the Ab in 2 days and reexamine only if symptoms recur
B) Voiding cystourethrography
C) IVP
D) cystoscopy
E) No furthertesdng

[ArchivalUser]

e.

[ArchivalUser]

B

[ArchivalUser]

e - the present recommendation is not to investigate first uti even in children or males.but correct me if wrong

[ArchivalUser]

please 3 steps state your source.

because as i know any uti in a boy should be investigated.

in case of girls if she is less than 5 years old even 1st episode of uti should be investigated.

and girl>5 years should be investigated in case of 2 episodes of uti.

[ArchivalUser]

I also agree on E since this is his 1st UTI

[ArchivalUser]

always a VCUG in a boy with first uti before age 2.... could be post ureth valve....later investigation with a girl....