American Board of Internal Medicine (ABIM) Certification Practice Exam

Patients with isolated hematuria and a family history of hematuria may require what type of monitoring?

1. Regular imaging scans

2. Serial measurements of kidney function and urine protein

3. Frequent blood transfusions

4. Psychological evaluation

The correct answer is: Serial measurements of kidney function and urine protein

In patients presenting with isolated hematuria, especially when there is a family history of hematuria, it is essential to monitor kidney function and assess urine protein to evaluate for any underlying renal pathology. The presence of hematuria can be indicative of various conditions, including glomerular diseases, urinary tract abnormalities, or hereditary disorders such as Alport syndrome. Measuring kidney function, typically through serum creatinine and calculating estimated glomerular filtration rate (eGFR), allows for the early detection of any renal impairment that may develop over time. Additionally, monitoring urine protein levels helps identify nephron damage or glomerular disease, which could suggest a worsening condition requiring further intervention. Regular imaging scans, while potentially useful for assessing structural abnormalities, do not provide information on kidney function or the presence of significant proteinuria, which are critical for determining the management of these patients. Frequent blood transfusions would not be appropriate in the management of isolated hematuria and could pose unnecessary risks. Psychological evaluation is not indicated solely based on hematuria, making it an unsuitable choice in this scenario. The necessity of serial measurements of kidney function and urine protein helps ensure that any progression of kidney disease or development of complications can be promptly identified and addressed,