Evaluation of Hematuria Bernard M. Karnath, MD 1. A 50-year-old man presents with a 3-week history of hematuria. He has no other medical illnesses but reports a 30-pack-year history of smoking. He reports that the hematuria is most prominent at the end of urination. The patient denies pain and does not have any family members with renal failure. Which of the following is the most likely diagnosis? Nephrolithiasis Polycystic kidney disease Thin basement membrane disease Tumor of the bladder neck Click here to compare your answer. 2. A 20-year-old man presents with episodes of hematuria. He reports a history of kidney stones 3 years ago. Family history is significant for a father with end-stage renal disease. Which of the following is the most likely diagnosis? Alport’s syndrome Polycystic kidney disease Renal cell carcinoma Thin basement membrane disease Click here to compare your answer. 3. A 20-year-old woman presents with episodes of dark urine. She recalls having an upper respiratory infection with cough, sore throat, and myalgias about 1 week prior to the hematuria episode. Physical examination is normal as are the results of laboratory testing, including complete blood count, blood urea nitrogen, serum creatinine, serum electrolytes, and serum complement. Antinuclear antibody assay is negative. Urinalysis shows many red blood cells. Which of the following is the most likely diagnosis? Alport’s syndrome Henoch-Schönlein Purpura IgA nephropathy Poststreptococcal glomerulonephritis Click here to compare your answer. 4. A 30-year-old woman presents with acute onset of edema and hematuria. Approximately 3 weeks ago, she was treated for pharyngitis with oral penicillin. Since that time she has felt well but has noticed the onset of dark, cola-colored urine and swelling of her legs. On physical examination, blood pressure is 160/110 mm Hg and there is marked peripheral edema. Serum complement levels are low. Urinalysis shows many red blood cells. Which of the following is the most likely diagnosis? Alport’s syndrome Henoch-Schönlein purpura IgA nephropathy Poststreptococcal glomerulonephritis Click here to compare your answer. 5. A 30-year-old man presents with right flank pain associated with gross hematuria. The physical examination reveals costovertebral angle tenderness. Urinalysis reveals 3+ heme, no protein, 40 red blood cells per high-power field (hpf), occasional white blood cells per hpf, and no bacteria. A plain radiograph of the abdomen and pelvis is normal. Spiral computed tomography (CT) without contrast shows a bright 2-cm object in the right renal pelvis with slight right hydronephrosis. Which material is this stone most likely composed of? Calcium Cystine Struvite Uric acid Click here to compare your answer. Click here to read more about Evaluation of Hematuria (Requires Adobe Acrobat Reader) Check our archives to test your knowledge in other clinical signs: If you do not already have Acrobat Reader, simply click on the icon below, scroll down to the "Get the Free Acrobat Reader" heading and follow the instructions to install the program. Acrobat enables you to convert any document into an Adobe Portable Document Format (PDF) file for easy viewing. Download Adobe Acrobat Reader   Hospital Physician     JCOM     Seminars in Medical Practice Hospital Physician Board Review Manuals About TWC    Subscribe    Contact TWC    Home    Search   Site Map Copyright © 2008, Turner White Communications Updated 1/04/08 • kkj