Pyelonephritis: The Daily PANCE Blueprint
A 22-year-old G1P0 female at 28 weeks gestation with a history of diabetes presents to the clinic with fever, chills, and dysuria. Vitals show tachycardia (115 bpm), tachypnea (22 bpm), and hypotension (90/58 mmHg). Physical exam reveals suprapubic tenderness. Labs reveal leukocytosis, hyponatremia, and hyperglycemia. Urine dipstick is positive for nitrites, blood, glucose, and ketones. Which of the following is the next best step?
A. Send home with oral antibiotics and analgesics
B. Reassurance and oral rehydration solution
C. Admit to hospital for antibiotics, fluids, & insulin
D. Order outpatient CT scan of the abdomen
E. Refer to an outpatient nephrologist for workup
Smarty PANCE Content Blueprint Review:
Covered under ⇒ PANCE Blueprint Genitourinary ⇒ Infectious Disorders ⇒ Pyelonephritis
Also covered as part of the Family Medicine EOR, Internal Medicine EOR, Emergency Medicine EOR topic list
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