The following are multiple choice questions (with answers) about medical knowledge.   **Question:** A 64-year-old man comes to the emergency department because of a 2-day history of lower back pain, fever, and chills. He has had nausea but no vomiting during this time. He has hypertension, chronic kidney disease, and type 2 diabetes mellitus. Three months ago, he underwent amputation of his left third toe because of a non-healing ulcer. He has smoked a pack of cigarettes daily for 48 years. Current medications include hydrochlorothiazide, metoprolol, and insulin. His temperature is 39.4°C (102.9°F), pulse is 102/min, blood pressure is 150/94 mm Hg, and respirations are 18/min. Examination shows a 1-cm (0.4-in) round ulcer on the sole of his right foot. There is costovertebral angle tenderness on the left side. The abdomen is soft. Laboratory studies show: Hemoglobin 11.5 g/dL Leukocyte count 19,000/mm3 Serum Na+ 140 mEq/L Cl− 102 mEq/L K+ 5.0 mEq/L HCO3− 25 mEq/L Urea nitrogen 65 mg/dL Creatinine 2.4 mg/dL Glucose 240 mg/dL Urine Blood 1+ Protein 1+ WBC 100/hpf Nitrite 2+ WBC casts numerous Urine and blood samples for culture and sensitivity tests are obtained. Which of the following is the most appropriate next step in management?"   (A) Inpatient treatment with intravenous ciprofloxacin   (B) Outpatient treatment with oral levofloxacin   (C) Outpatient treatment with trimethoprim-sulfamethoxazole   (D) Initiate hemodialysis
['(A) Inpatient treatment with intravenous ciprofloxacin <> answer', 'The following are multiple choice questions (with answers) about medical knowledge. <> instruction', '(A) Inpatient treatment with intravenous ciprofloxacin \n (B) Outpatient treatment with oral levofloxacin \n (C) Outpatient treatment with trimethoprim-sulfamethoxazole \n (D) Initiate hemodialysis <> possible answers', '  A 64-year-old man comes to the emergency department because of a 2-day history of lower back pain, fever, and chills. He has had nausea but no vomiting during this time. He has hypertension, chronic kidney disease, and type 2 diabetes mellitus. Three months ago, he underwent amputation of his left third toe because of a non-healing ulcer. He has smoked a pack of cigarettes daily for 48 years. Current medications include hydrochlorothiazide, metoprolol, and insulin. His temperature is 39.4°C (102.9°F), pulse is 102/min, blood pressure is 150/94 mm Hg, and respirations are 18/min. Examination shows a 1-cm (0.4-in) round ulcer on the sole of his right foot. There is costovertebral angle tenderness on the left side. The abdomen is soft. Laboratory studies show:\nHemoglobin 11.5 g/dL\nLeukocyte count 19,000/mm3\nSerum\nNa+ 140 mEq/L\nCl− 102 mEq/L\nK+ 5.0 mEq/L\nHCO3− 25 mEq/L\nUrea nitrogen 65 mg/dL\nCreatinine 2.4 mg/dL\nGlucose 240 mg/dL\nUrine\nBlood 1+\nProtein 1+\nWBC 100/hpf\nNitrite 2+\nWBC casts numerous\nUrine and blood samples for culture and sensitivity tests are obtained. Which of the following is the most appropriate next step in management?" <> context@']