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Hematuria MCQ

1) A 32-year-old woman, taking oral contraceptives, is seen for recurrent flank pain. Imaging tests reveal normal sized kidneys, no obstruction and no stones. Renal function is normal and urinalyses and urine cultures are negative. The likely diagnosis is:
a) Factitious hematuria
b) Loin pain/hematuria syndrome
c) Atheroembolic renal disease
d) Thrombotic microangiopathy
e) IgA nephropathy

2) A 68-year-old elderly gentleman with generalized atherosclerosis is seen one week past cardiac catheterization for a slowly rising serum creatinine concentration. He has lost his appetite but is otherwise asymptomatic. Urinalysis shows only 1+ proteinuria and 5-10 red blood cells per high power field. The likely diagnosis is:
a) Loin pain/hematuria syndrome
b) IgA nephropathy
c) Wegener’s granulomatosis
d) Atheroembolic renal disease
e) Acute tubular necrosis

3) A 48-year-old unemployed, single mother of three is seen because of microscopic hematuria, pyuria, mild proteinuria (1+) and a serum creatinine of 1.4 mg/dl. She has no rash. She has been diagnosed with fibromyalgia and takes a number of over-the-counter medications. Urine cultures are sterile. CBC reveals 8% eosinophils. The most likely diagnosis is:
a) Renal tuberculosis
b) Phenacetin nephropathy
c) Thin basement membrane disease
d) IgA nephropathy
e) Allergic interstitial nephritis

4) An otherwise healthy 18-year-old African-American is seen because of recurrent painless hematuria without pyuria or proteinuria. Physical examination , CBC, urinalysis, urine culture, and renal function tests are all normal. There is no evidence of papillary necrosis on imaging tests. The likely diagnosis is:

a) Sickle cell trait
b) Thin basement membrane disease
c) Allergic interstitial nephritis
d) Thrombotic microangiopathy
e) Renal tuberculosis

5) A sexually-active 30-year-old woman is seen because of acute dysuria, gross hematuria and minimal left flank pain. She is afebrile. She had one similar episode four years earlier. Urinalysis reveals 50-100 wbcs, and 20-30 rbcs/hpf. A urine culture is ordered. Statistically, the offending organism is likely to be:
a) Klebsiella
b) E.coli
c) Proteus
d) Mycobacterium tuberculosis
e) Staphylococcus aureus

Answers

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