A 64-Year-Old Man Comes to the Office for Follow-Up After

question 437

Multiple Choice

A 64-year-old man comes to the office for follow-up after a recent hospitalization.  Ten days ago, he was admitted due to fever, dysuria, urinary urgency, and perineal pain.  Evaluation revealed acute prostatitis, and urine culture was positive for Escherichia coli that was sensitive to all tested antibiotics.  He received intravenous ciprofloxacin with improvement in his symptoms and was subsequently discharged on oral ciprofloxacin.  The patient has been taking the antibiotic as prescribed, but over the past 2 days he has had recurrent fever and dysuria.  He takes diltiazem for palpitations, atorvastatin for hyperlipidemia, and an over-the-counter antacid for frequent heartburn.  Temperature is 37.3 C (99.1 F) , blood pressure is 118/68 mm Hg, and pulse is 90/min.  Physical examination shows a mildly enlarged and tender prostate.  Repeat urine culture grows E coli.  Which of the following is the most likely cause of this patient's recurrent symptoms?

• A)Acquired antibiotic resistance
• B)Decreased drug bioavailability
• C)Exposure to untreated sexual partner
• D)Increased renal drug clearance
• E)Induction of hepatic CYP enzymes

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Definitions:

Variation

In statistics, it refers to the measure of the spread or dispersion of a set of data points or values in a dataset.

Explanatory Variables

Variables in a statistical model that are used to explain variance in the dependent variable; also known as independent variables.

Sales

The exchange of a commodity for money; the action of selling something.

Least Significant

Refers to the component of a data set, measurement, or statistical result that contributes the least impact or importance.