APEA 3P Exam PrepNephrology/GU Questions with Correct Answers and Explanations
A 79-year-old female patient with urinary frequency is found to have a UTI. What medication could produce arrhythmias in her? Doxycycline Amoxicillin Ciprofloxacin Macrodantin Ciprofloxacin is a quinolone antibiotic. All quinolones have the potential to produce prolongation of the QT interval. It should be prescribed with caution in older adults. Mrs. Jackson complains of urinary incontinence when she laughs or sneezes. What should be used first line to treat her symptoms? Kegel exercises Prescribe oxybutynin Avoid caffeine and alcohol Minimize fluids at nighttime This patient has stress incontinence. The first-line approach with these patients is to attempt to strengthen the pelvic floor muscles. Appropriate performance of Kegel exercises is key. Prescribing an anticholinergic might worsen incontinence because it will cause urinary retention. Avoiding caffeine and alcohol is especially helpful for people with urge incontinence, but could have a minimal benefit for this patient. However, this does not address the underlying problem, weak pelvic muscles. Minimizing fluids at nighttime will help if nocturia is a problem. A 76-year-old male presents with urethral irritation after voiding. If sexually transmitted diseases and urinary tract infection are ruled out, what is another etiology? Acute bacterial prostatitis Chronic prostatitis Epididymitis Asymptomatic bacteriuria Chronic prostatitis can produce these symptoms. Sometimes this is accompanied by perineal pain, but the patient may have a normal prostate exam. Acute bacterial prostatitis patients will present with fever, chills. Examination of the prostate gland reveals a tender, boggy prostate gland. Epididymitis can produce scrotal pain, not dysuria or irritation with voiding. Asymptomatic bacteriuria is asymptomatic. These patients don’t know they have this because they have no symptoms. A healthy 32-year-old female has left flank pain and nausea. What is the most likely diagnosis? Urinary tract
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apea 3p exam pre3