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Old 08-03-2011
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Question Lab finding in darker urine

A 70-year-old man has noted passing darker urine for the past week. On physical examination he has vital signs with T 37.1 C, P 73/minute, RR 16/minute, and BP 130/80 mm Hg. Laboratory studies include urinalysis with sp gr 1.015, pH 7, 2+ blood, no glucose, no protein, and no ketones. Urine microscopic examination shows 10 to 15 RBC/hpf and no WBCs, casts, or crystals. Cystoscopy is performed and no lesions are noted. Intravenous urography shows a 2 cm filling defect in the left renal pelvis. Which of the following laboratory test findings is most likely to be present in this man?

A Polycythemia

B Leukocytosis

C Hypercalciuria

D Positive serology for antinuclear antibody

E Urine cytology with atypical cells
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Old 08-03-2011
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Quote:
Originally Posted by usmle2011 View Post
A 70-year-old man has noted passing darker urine for the past week. On physical examination he has vital signs with T 37.1 C, P 73/minute, RR 16/minute, and BP 130/80 mm Hg. Laboratory studies include urinalysis with sp gr 1.015, pH 7, 2+ blood, no glucose, no protein, and no ketones. Urine microscopic examination shows 10 to 15 RBC/hpf and no WBCs, casts, or crystals. Cystoscopy is performed and no lesions are noted. Intravenous urography shows a 2 cm filling defect in the left renal pelvis. Which of the following laboratory test findings is most likely to be present in this man?

A Polycythemia

B Leukocytosis

C Hypercalciuria

D Positive serology for antinuclear antibody

E Urine cytology with atypical cells
@dr_lizard...I think you are right! E)

Last edited by bebix; 08-03-2011 at 04:34 PM.
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Old 08-03-2011
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i changed my mind E more reasonable
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Last edited by dr_lizard; 08-03-2011 at 03:36 PM.
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Old 08-03-2011
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Quote:
Originally Posted by usmle2011 View Post
A 70-year-old man has noted passing darker urine for the past week. On physical examination he has vital signs with T 37.1 C, P 73/minute, RR 16/minute, and BP 130/80 mm Hg. Laboratory studies include urinalysis with sp gr 1.015, pH 7, 2+ blood, no glucose, no protein, and no ketones. Urine microscopic examination shows 10 to 15 RBC/hpf and no WBCs, casts, or crystals. Cystoscopy is performed and no lesions are noted. Intravenous urography shows a 2 cm filling defect in the left renal pelvis. Which of the following laboratory test findings is most likely to be present in this man?

A Polycythemia

B Leukocytosis

C Hypercalciuria

D Positive serology for antinuclear antibody

E Urine cytology with atypical cells
70 yr old painless hematuria n filling defect E
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Old 08-03-2011
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cancer here seems likely...his age-painless-although renal ca can cause pain ...
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Old 08-04-2011
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why cant it be a renal stone?
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Old 08-04-2011
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Most Common cause of hematuria - tumor.E) atypical cells
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Old 08-04-2011
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Default Explanation

(A) Incorrect. Polycythemia would be a paraneoplasatic effect expected with a renal cell carcinoma.

(B) Incorrect. Such a filling defect is unlikely to be an abscess, and there are no WBCs in the urine. He is afebrile

(C) Incorrect. It is unlikely to be a calculus in the absence of crystals in the urine.

(D) Incorrect. Lesions of the pelvis are unlikely to be associated with autoimmune diseases.

(E) CORRECT. The mass is probably a urothelial carcinoma, and atypical cells would appear in the urine.
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