CHAPTER 1 Evaluation of the Urologic Patient 51
Key Points
•A urologist should systematically perform a complete urologic history and physical exam considering a broad differential for the presenting chief complaint.
•Itisimportanttoconsiderallcomponentsofapatient’sstatusincluding social history and performance status as well as special considerations for certain populations including children and the elderly.
•A dipstick urine test alone is inadequate for the diagnosis of microscopic hematuria. AMH must be demonstrated by 3 RBC/ HPF on microscopic examination.
•Urine cytology is not recommended during initial workup for
AMH, however it is specific for high-grade UCC.
•A CT urogram is sensitive and specific for upper tract urothelial cell carcinoma and is a study used during workup of hematuria.
•A CT noncontrast study of the abdomen and pelvis is key for evaluating urolithiasis with the exception of indinavir stones.
•For a renal mass on MRI, the most important characteristic indicating malignancy is enhancement.
Molecular imaging for urologic malignancies is most often performed using the PET radiotracer 2-deoxy-2-[18 F]fluoro-D-glucose (18 F-FDG).
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52 CHAPTER 1 Evaluation of the Urologic Patient
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