A 26yo man presents with painless hematuria.

He has no other complaints and on examination no other

abnormality is found. What is the most appropriate initial inv to get to a dx?

a. Cystoscopy

b. Midstream urine for culture

c. Abdominal US

d. MRI spine

e. Coag screening

Ans. Ans. The key is C. Abdominal ultrasound. [Abdominal US to exclude polycystic disease, malignancy,
tumour, urolithiasis etc].

A pt, 50yo smoker and heavy drinker, presents with complaints of racing heart. A 24h EKG comes out
normal. What is your next step in management?

a. Echo

b. Reassure

c. Stress test

Ans. The key is B. Reassure. [Racing heart or palpitation is a common phenomenon in alcoholics which is
not serious or harmful. So reassure the patient].

A 36yo woman came with uterine bleeding. Vaginal US reveals uterine thickness=12mm. what is the
most probable dx?

a. Cervical ca

b. Endometrial ca

c. Ovarian ca

d. Breast ca
e. Vaginal ca

Ans. The key is B. Endometrial Ca. [Actually it is endometrial thickness and in general 12 mm means
hyperplasia which may suggest endometrial Ca. in this woman].

. A 30yo woman has PID which was treated with metronidazole and cephalosporin. It is getting
worse. What is the next best inv?

a. Endocervical swab

b. US

c. Laparotomy

d. High vaginal swab

Ans. The key is B. US. [Probable tubo-ovarian abscess].