A 52 year old man has been referred to you by his general practitioner because of the recent development of macroscopic haematuria.
Question
a. Describe your assessment of this patient. (80%) b. Outline your disposition of this patient. (50%)
Answer
FACEM VAQ Exam 2004.1 – Question 3
- The overall pass rate for this question was 57 / 69 (82.6%).
- Examiners expected that the history sought would include questions about pain, urinary symptoms and relevant past history (such as use of anticoagulants).
- Examination needed to include vital signs (especially temperature) and a thorough abdominal palpation.
- It was expected that investigation would include urinalysis and culture, renal function, full blood count, coagulation studies and renal tract imaging.
- In the section on disposition it was expected that specific admission/discharge criteria would be identified and that it would be stated which service would follow up and why.
- The commonest reason for failure was not addressing important differentials in the assessment section. Some candidates neglected to examine the patient or perform a confirmatory urinalysis.
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