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Acute uncomplicated cystitis — USMLE Step 3 MCQ

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EasyAmbulatory Medicine / Primary CareAcute uncomplicated cystitisUSMLE Step 3

A 26-year-old nonpregnant woman has dysuria and urinary frequency for 1 day. She has no fever, flank pain, vaginal discharge, or recent antibiotic use. Urinalysis shows leukocyte esterase and nitrites. Kidney function is normal. Which of the following is the most appropriate next step in management?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: E — Treat with nitrofurantoin

Uncomplicated cystitis can be treated empirically with nitrofurantoin when pyelonephritis and vaginal symptoms are absent.

Reference: Current US clinical practice standards and USMLE Step 3 content outline, https://www.usmle.org/exam-resources/step-3-materials