American Board of Internal Medicine (ABIM) Certification Practice Exam

Imaging with CT or ultrasonography is recommended for hospitalized pyelonephritis patients if fever persists for how many hours?

1. 24 hours

2. 48 hours

3. 72 hours

4. 96 hours

The correct answer is: 72 hours

In the context of hospitalized patients with pyelonephritis, it is important to evaluate the condition further if the patient continues to exhibit fever despite appropriate antibiotic treatment. The recommendation is to utilize imaging techniques such as CT scan or ultrasonography if fever persists for 72 hours after initiating treatment. This 72-hour window is critical because it allows healthcare providers to determine whether there are complications such as abscess formation or obstructive processes that may be contributing to the patient's ongoing symptoms. In cases of pyelonephritis, failing to respond adequately to antibiotics within this timeframe can suggest an underlying issue requiring further investigation. Therefore, employing imaging within this specific period is a guideline to ensure timely and effective management of potentially serious complications that may need different therapeutic interventions. Delaying imaging beyond this period could lead to complications such as renal damage or sepsis, making early assessment crucial to patient outcomes. This targeted approach helps in the proper assessment and management of the patient’s condition, thereby improving their chances of recovery.