A 6-Year-Old Boy Is Brought to the Office Due to Bright

question 713

Multiple Choice

A 6-year-old boy is brought to the office due to bright red blood in the urine for the past day.  He has had no dysuria, urgency, frequency, or pain.  There is no history of trauma.  He has no chronic medical conditions or recent infections and takes no medications.  Temperature is 98.6 F (37 C) , pulse is 80/min, blood pressure is 100/65 mm Hg, and respirations are 20/min.  Examination shows normal cardiopulmonary, abdominal, and genital examinations.  There is no flank or suprapubic tenderness.  There is no edema.  Laboratory results are as follows: Which of the following is the most appropriate next step in management of this patient?

• A)24-hour urine protein measurement
• B)CT scan of the abdomen without contrast
• C)Cystoscopy
• D)Kidney biopsy
• E)Renal and bladder ultrasound

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