A 46-year-old woman arrives with flank pain, fever, and vomiting. Triage acuity is ESI 2; T 102.9 F, BP 94/58 mm Hg, HR 124/min. Urinalysis shows

Question

A 46-year-old woman arrives with flank pain, fever, and vomiting. Triage acuity is ESI 2; T 102.9 F, BP 94/58 mm Hg, HR 124/min. Urinalysis shows pyuria and nitrites. CT shows a 7-mm obstructing proximal ureteral stone with hydronephrosis. Which of the following is the most appropriate disposition?

Accepted Answer

Admit for IV antibiotics and urgent urologic decompression

Answer

Schedule elective lithotripsy in 2 months

Answer

Discharge with tamsulosin and oral analgesia

Answer

Observe until fever resolves without antibiotics

Answer

Give oral fluids and outpatient follow-up

Renal colic infected obstruction — ABEM Board MCQ

A 46-year-old woman arrives with flank pain, fever, and vomiting. Triage acuity is ESI 2; T 102.9 F, BP 94/58 mm Hg, HR 124/min. Urinalysis shows pyuria and nitrites. CT shows a 7-mm obstructing proximal ureteral stone with hydronephrosis. Which of the following is the most appropriate disposition?