A 60-year-old man with a history of well-controlled hypertension and no family history of malignancy presents with persistent asymptomatic microscopic hematuria detected on routine urinalysis. The patient denies any recent trauma, vigorous exercise, or urinary tract infections. He is a non-smoker and reports no other symptoms such as dysuria, urgency, or flank pain. His renal function is normal, and a urine culture is negative. A CT urography reveals no abnormalities in the kidneys or upper urinary tract. What is the next best step in the evaluation of this patient’s hematuria?
A 50-year-old man from a schistosomiasis-endemic region presents with weight loss, hematuria, and lower abdominal pain. Biopsy of a bladder lesion confirms squamous cell carcinoma, and urinalysis detects Schistosoma haematobium eggs. He asks about prevention for his family. Which of the following is the most effective public health measure to reduce the incidence of Schistosoma haematobium-related bladder squamous cell carcinoma in his community?
A 32-year-old woman from Egypt presents with dysuria, hematuria, and a palpable pelvic mass. She has a history of recurrent urinary infections since childhood. Cystoscopy reveals a thickened bladder wall with granulomas, and histology shows carcinoma with calcified eggs. What is the primary pathological process initiated by Schistosoma haematobium that increases the risk of bladder carcinoma in this patient?
A 45-year-old man from a rural area in sub-Saharan Africa presents with persistent hematuria and pelvic pain for six months. He reports swimming in local rivers as a child. Imaging reveals a mass in the bladder, and biopsy confirms squamous cell carcinoma. Urine microscopy shows eggs with a terminal spine. Which of the following is the most likely causative agent linking this patient’s infection to bladder squamous cell carcinoma?
A 52-year-old woman from sub-Saharan Africa presents with a year-long history of intermittent hematuria and recent onset of urinary frequency and suprapubic pain. She has a history of untreated Schistosoma haematobium infection. Cystoscopy reveals a mass in the bladder. Biopsy of the mass is most likely to show which of the following histological findings?
A 45-year-old male from a rural area in Egypt presents with painless hematuria that has persisted for several months. He reports frequent exposure to freshwater sources during his daily activities. Urine microscopy reveals terminal-spined ova. Which of the following is the most likely diagnosis?
A 35-year-old African American man presents to the clinic with worsening fatigue, swelling in his legs, and foamy urine for the past two weeks. His medical history is significant for untreated HIV infection, diagnosed 5 years ago. He has not been taking antiretroviral therapy regularly. On physical examination, he has bilateral lower extremity edema and elevated blood pressure. Laboratory tests reveal heavy proteinuria, hypoalbuminemia, and elevated serum creatinine. A kidney biopsy confirms focal segmental glomerulosclerosis. The physician suspects a diagnosis related to his underlying HIV infection. Question: Which of the following best describes the pathophysiology of HIV-1–associated nephropathy (HIVAN)?
A 6-year-old boy with minimal change disease (MCD) on high-dose corticosteroids develops abdominal pain and vomiting. On examination, he has diffuse abdominal tenderness and guarding. What is the most likely complication in this patient?
A 6-year-old boy with a history of minimal change disease (MCD) treated with prednisone has relapsed after a month off medication. His parents ask about long-term outcomes and treatments. Which of the following statements best describes the long-term prognosis for this child with minimal change disease?
A 5-year-old girl, diagnosed with MCD after presenting with nephrotic syndrome, has been started on corticosteroids. Two weeks into treatment, her edema has resolved, and proteinuria has significantly decreased. Which of the following is the most appropriate next step in the management of this patient?
