A 58-year-old woman presents with two days of right loin pain radiating to the groin, associated with shaking chills. Her temperature is 38.9°C, pulse 118/min and blood pressure 96/58 mmHg. Non-contrast CT of the urinary tract shows a 9 mm calculus at the right pelviureteric junction with moderate hydronephrosis; the left kidney is normal. Blood tests show a white cell count of 18.2 x 10^9/L (4.0-11.0) and creatinine 152 micromol/L (45-90). Intravenous fluid resuscitation, analgesia and intravenous antibiotics have been commenced. Which one of the following is the most appropriate next step in management?
More from AMC
See allA 17-year-old girl presents six hours after a deliberate ingestion of tablets taken from the family bathroom cabinet. She complains of nausea, repeated vomiting…
A 28-year-old woman is brought in by ambulance 90 minutes after being found drowsy next to an empty box of amitriptyline. Her Glasgow Coma Scale score is 12, he…
A 21-year-old man collapses at the 14 km mark of a city fun run on a 34°C day. In the trackside medical tent he is confused and agitated with a Glasgow Coma Sca…
A 26-year-old backpacker is snorkelling off Port Douglas in far north Queensland in December when she feels a mild sting on her forearm, leaving only faint redn…
A 34-year-old man in suburban Sydney felt a sharp pinprick on the back of his hand while moving pot plants stacked against the house. Over the next two hours he…