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What is A 60 year old smoker came with the history of single episode of painless gross hematuria . Most logical investigation would be. and explain in detail?
REPEAT QUESTION. In this case, we should suspect bladder carcinoma ( transitional cell carcinoma ) . RISK FACTORS:- 1.Smoker :- component of tobacco - 4 aminobiphenyl. 2. Cyclophosphamide.(Phenacitin also) 3.Schistosomiasis in endemic regions . 4.Chemical (Aromatic hydrocarbon -Aniline). 5.Stones. 6.Radiation. 7.F.B. It is more common in males -3:1. They usually presents with painless gross hematuria. IOC :-Thus the best option here is urine microsopy for RBC's and malignant cells.urine cytology even though not a good screening test because of lack of sensitivity is highly specific . Mainstay of diagnosis is cystourethroscopy. investigations include imaging ( CT , MRI ,USG ,IVU ) and blood investigations for HB , electrolytes and urea . Gold std:- CYSTOSCOPY Bailey and Love 27th edition.chapter 77.pg no 1449.