Question 1

An older male patient reports gross hematuria but denies flank pain and fever. What will the provider do to manage this patient?&#10;A) Monitor blood pressure closely&#10;B) Obtain a urine culture&#10;C) Perform a 24-hour urine collection&#10;D) Refer for cystoscopy and imaging

Accepted Answer

Gross hematuria in an older male patient warrants further evaluation, including cystoscopy and imaging, to rule out potential malignancy of the urinary tract. Monitoring blood pressure and obtaining a urine culture may be appropriate in other contexts, but they would not be the first-line management choices for gross hematuria in an older male patient. A 24-hour urine collection is not relevant to the initial evaluation of gross hematuria.

Question 2

A pregnant woman at 30 weeks gestation presents with proteinuria. What will the provider do next?&#10;A) Evaluate her blood pressure and discuss with OB/GYN&#10;B) Monitor serum glucose for gestational diabetes&#10;C) Perform a 24-hour urine collection&#10;D) Reassure her that this normal at this stage of pregnancy

Accepted Answer

Proteinuria at 30 weeks gestation can be a sign of preeclampsia, a serious pregnancy complication that can lead to maternal and fetal morbidity and mortality. Evaluating the woman's blood pressure and consulting with an OB/GYN is the next appropriate step in management. Monitoring for gestational diabetes or performing a 24-hour urine collection may be indicated as well, but the immediate concern is ruling out preeclampsia. Reassuring the woman that this is normal at this stage of pregnancy is inappropriate and potentially dangerous.

Question 3

A female patient reports hematuria and a urine dipstick and culture indicate a urinary tract infection. After treatment for the urinary tract infection (UTI), what testing is indicated for this patient?

A) 24-hour urine collection to evaluate for glomerulonephritis
B) Bladder scan
C) Repeat urinalysis
D) Voiding cystourethrogram

C

Accepted Answer

After treatment for a UTI, a repeat urinalysis is indicated to confirm resolution of the infection. A 24-hour urine collection is not necessary unless there is suspicion for glomerulonephritis or other renal pathology. A bladder scan and voiding cystourethrogram are not indicated in this scenario.

Deck 130: Proteinura and Hematuria