What is the first test to perform in a patient presenting with hematuria?

• A. Urinalysis
• B. CT scan
• C. Cystoscopy
• D. Ultrasound

Answer: (A)

Performing a urinalysis is the first test recommended for a patient presenting with hematuria. This test is crucial because it allows for the immediate assessment of urine for the presence of blood, the number of red blood cells, and other potential abnormalities such as protein, glucose, or signs of infection. Urinalysis is non-invasive, quick, and can provide valuable information that guides further diagnostic approaches.

Post urinalysis, the findings from the test dictate additional evaluations. If hematuria is confirmed and especially if there are associated risk factors or additional symptoms, further imaging studies or procedures, such as a CT scan, ultrasound, or cystoscopy, may be warranted. Each of these follow-up tests serves specific purposes, such as assessing for urinary tract stones, masses, or lesions, but they are not the initial step in the diagnostic pathway. Starting with urinalysis helps establish the basis for further diagnostic investigation effectively.