219 ) A 32 year old woman presents to the office for evaluation of recurrent urinary tract infections. She has had two episodes of cystitis in the last 4 months. In the past she was managed with 3 day course of trimethoprim-sulfamethoxazole. Now, she presents with burning micturition, urgency and frequency. She denies flank pain or fever. She uses diaphragms with spermicide for contraception. She is sexually active with one partner and her last sexual intercourse was 5 months ago since her partner is away on a business tour. Physical examination is normal except for mild supra-pubic tenderness. Which of the following is the most appropriate recommendation to avoid recurrent urinary tract infections in this patient?
A) Post-coital voiding
B) Post-Coital Trimethoprim-sulfamethoxazole
C) Avoid vaginal spermicides
D) CT urogram and Cystoscopy
E) Daily Trimethoprim-Sulfamethoxazole
Filed under: USMLE Test Prep | Tagged: Archer Infectious Diseases, ARCHER NEPHROLOGY, ARCHER UROLOGY, USMLE STEP 3 INFECTIOUS DISEASES, usmle step 3 nephrology, usmle step 3 urology |
Archer USMLE Step 3 Blog 
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Recurrent urinary tract infections (UTIs), also known as chronic urinary tract infections, are defined as having at least 2 infections in 6 months, or 3 infections in 1 year. Often, they are caused by a type of bacteria that is different from the infection before it, which means that the new infection is separate from the last infection. One treatment option for recurrent UTIs involves taking low doses of antibiotics daily for at least 6 months. Steps that may help prevent UTIs include drinking plenty of water, taking showers instead of baths, and drinking cranberry juice.
B. is more releated to coit
E
e
because not related to sexual activity
common sense qt:P
E:) Recurrent UTI not related to sexual activity