Quiz 68

Question 1

A 44-year-old male sees you for evaluation of an episode of pink-tinged urine last week. He denies any flank or abdominal pain, as well as frequency, urgency, and dysuria. He has no prior history of renal or other urologic disease, and no other significant medical problems. He has a 24-pack-year smoking history. A urinalysis today reveals 8–10 RBCs/hpf. You refer him to a urologist for cystoscopy.
Which one of the following would be the most appropriate additional evaluation?

Answer 1

CT urography or intravenous pyelography is recommended by the American College of Radiology as the most appropriate imaging procedure for hematuria in all patients, with the exception of those with generalized renal parenchymal disease, young women with hemorrhagic cystitis, children, and pregnant females.

Question 2

The test of choice for immediate evaluation of an acutely swollen scrotum is:

Answer 2

Any patient with a new scrotal mass should be evaluated immediately because of the risk of potential emergencies, such as testicular torsion, or of life-threatening diseases such as testicular carcinoma. Color Doppler ultrasonography is the test of choice for immediate evaluation of scrotal masses (SOR B) because it can be done quickly and has a high sensitivity (86%–88%) and specificity (90%–100%) for detecting testicular torsion, which is a surgical emergency

Question 3

A 58-year-old male complains of leg claudication. Subsequent tests reveal that he has significant bilateral peripheral arterial disease. His current medications include atenolol (Tenormin), 50 mg/day, and aspirin, 325 mg/day. His blood pressure is 128/68 mm Hg, and his pulse rate is 64 beats/min. His LDL-cholesterol level is 123 mg/dL.

The addition of which one of the following could reduce this patient’s symptoms?

Answer 3

Simvastatin (Zocor)