CTAS 2: A 63-year-old has flank pain, fever and rigors. Vitals are T 39.3°C, BP 86/48, HR 126. Urinalysis shows nitrites and pyuria; creatinine is

Question

CTAS 2: A 63-year-old has flank pain, fever and rigors. Vitals are T 39.3°C, BP 86/48, HR 126. Urinalysis shows nitrites and pyuria; creatinine is 190 µmol/L. CT KUB shows a 7 mm proximal ureteric stone with hydronephrosis. What is the most appropriate next step?

Accepted Answer

Start IV antibiotics and arrange urgent urinary decompression

Answer

Discharge with oral analgesia and tamsulosin

Answer

Observe until the stone passes spontaneously

Answer

Delay treatment until urine culture results return

Answer

Give lithotripsy referral without antibiotics

Obstructing infected ureteric stone — RCPSC EM MCQ

CTAS 2: A 63-year-old has flank pain, fever and rigors. Vitals are T 39.3°C, BP 86/48, HR 126. Urinalysis shows nitrites and pyuria; creatinine is 190 µmol/L. CT KUB shows a 7 mm proximal ureteric stone with hydronephrosis. What is the most appropriate next step?