Uncomplicated cystitis — MCCQE Part 1 MCQ

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ModerateDysuriaUncomplicated cystitisMCCQE Part 1

A healthy 27-year-old non-pregnant woman has dysuria, frequency, no flank pain, no fever, no vaginal discharge and nitrites on urine dipstick. Which of the following is the most appropriate next step?

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Correct answer: C — Treat empirically for uncomplicated cystitis

Treat empirically for uncomplicated cystitis is the single best answer because the age, timing, examination findings and investigations in the vignette fit Uncomplicated cystitis better than the alternatives. The most tempting distractor is less appropriate because it either treats a neighbouring presentation, delays a time-critical intervention, or ignores a key discriminator in the stem. The remaining options are suboptimal because they would miss the diagnosis, use an investigation or treatment in the wrong sequence, or fail to address safety and follow-up. Canadian practice should be anchored to Canadian antimicrobial stewardship guidance, with attention to acuity, safety-netting and local provincial pathways.

Reference: Canadian antimicrobial stewardship guidance