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A 39-Year-Old Man Seeks Care for His Third Episode of Gross

question 586

Multiple Choice

A 39-year-old man seeks care for his third episode of gross hematuria. His first episode occurred shortly after onset of an upper respiratory infection 2 years ago. His most recent episode started about 5 days ago. Both episodes lasted 5-10 days and were not associated with either flank or abdominal pain. The episodes had accompanying mild dysuria. There were no blood clots passed. He has no other medical problems. He takes no medication. There is no family history of kidney disease.
His blood pressure is 132/90 mm Hg, pulse is 72/min, and respirations are 12/min. Physical examination shows no significant abnormalities.
The patient's laboratory studies show:

Using phase-contrast microscopy, the pathologist finds several dysmorphic red blood cells in the urine. Which of the following is the most appropriate next step in management?

Definitions:

Progression

The process of developing or moving forward towards a more advanced state.

Stages

Sequential phases or levels that represent progress or development in a process or a series of events, often used to describe disease progression or life cycles.

Healthy People 2020

A set of health objectives for the nation to achieve over the first decade of the 21st century, aimed at improving the health of all Americans.

Health Disparities

Preventable differences in the burden of disease, injury, violence, or opportunities to achieve optimal health that are experienced by socially and economically disadvantaged populations.