Analyzing urinary tract infections

Analyzing urinary tract infections
A 73-year-old man has developed diarrhoea following a course of antibiotics for
a suspected urinary tract infection. Stool
tests suggest he has developed Clostridium
difficile associated diarrhoea.
Which of the following criteria is most
suggestive of severe disease?
A. abdominal distension and generalised
B. creatinine 20% above baseline
C. glutamate dehydrogenase (GDH) test
D. temperature >37.5°C
E. white cell count >12 × 109/L
Question 15
A 79-year-old woman presents with a
one-week history of back pain in the lower
thoracic region. Two weeks ago, she was
treated with oral trimethoprim for a urinary
tract infection by her GP due to dysuria. Her
past medical history includes hypertension
and type 2 diabetes. Her observations show
temperature 37.8°C, blood pressure 146/77
and pulse 85 beats per minute. She is mildly
tender in the lower thoracic region, but the
rest of the examination is unremarkable.
Her initial investigation results are as
Which action would you take next?
A. request MRI scan of spine
B. request thoracic and lumber spine
C. send blood cultures
D. send urine for culture
E. start intravenous flucloxacillin
Question 16
A 72-year-old man presents to the
emergency department with painful
skin lesions. These have been rapidly
getting worse over the last two days. On
examination he looks unwell with blood
pressure 97/62, pulse 118 beats per
minute and temperature 38.5°C. There
is extensive blistering and epidermal
loss over about 20% of his body surface. He also has lesions affecting his
oral mucosa. His past medical history is
of ischaemic heart disease, COPD and
gout. He usually takes aspirin 75 mg od,
simvastatin 40 mg at night, allopurinol
200 mg od and a tiotropium inhaler
18 mcg daily. What is the most likely
A. bullous pemphigoid
B. dermatitis herpetiformis
C. exanthematous drug eruption
D. pemphigus vulgaris
E. Stevens-Johnson syndrome

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