huyniid
Forum Elite
Topics: 9
Posts: 195
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A 35 yo F is referred to you after being found to have blood in her urine during an insurance PE 2 days ago. She showed a normal insurance PE with the exception of 1+ blood on a urinalysis dipstick. She denied any current urinary symptoms and a complete review of systems is normal. She admitted to have 20 pack year Hx of tobacco use and near daily use of ibuprofen for aches and pains. She is sexually active, uses barrier contraception and had her last period 12 days ago. Vital signs and PE are within normal limits. Which of the following is the most appropriate first course of action
A. Blood Test, including BUN, Ceatinine and Tumor markers
B. Cystoscopy and upper urinary tract imaging study
C. Microscopic evaluation of urine
D. No further workup, given tobacco and NSAIDS use
E. 24-h urine analysis for protein and creatinin
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| 92306
Forum Senior
Topics: 14
Posts: 126
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C. Microscopic evaluation of urine
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| doc_clotaire
Forum Guru
Topics: 159
Posts: 1,303
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B ) Cystoscopy and UUTIS
hematuria + smoking +NSAIDS -----------------rule out bladder cancer
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| DrPak
Forum Elite
Topics: 49
Posts: 348
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I'm not sure if NSAIDs cause bladder cancer. I'm thinking papillary necrosis, but I'm stumped as to what the best answer to assess for papillary necrosis might be?
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| Geroo
Forum Guru
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Posts: 799
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I say B
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| oasis
Forum Newbie
Topics: 5
Posts: 19
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yes nsaids do cause bladder cancer on long term use so, rule out bladder pathology.ans is B
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| DrPak
Forum Elite
Topics: 49
Posts: 348
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According to this: http://cebp.aacrjournals.org/cgi/content/abstract/15/9/1696
...NSAIDs decrease bladder cancer risk, not increase it.
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| doc_clotaire
Forum Guru
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Please Post the answer !
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The elevator to succes is broke ,you must take the stairs
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| huyniid
Forum Elite
Topics: 9
Posts: 195
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C. is the right Ans. dipstick result for hematuria may give false positive, so microscopic urinalysis is warranted
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