Obstetrics & Gynecology>>>>>Preventive Care and Health Maintenance
Question 4#

You are following up on the results of routine testing of a 68-year-old G4P3 for her well-woman examination. Her physical examination was normal for a postmenopausal woman. Her Pap smear revealed parabasal cells, her mammogram and lipid profile was normal, and the urinalysis shows hematuria.

Which of the following is the most appropriate next step in the management of this patient?

A) Colposcopy
B) Endometrial biopsy
C) Renal sonogram
D) Urine culture
E) No further treatment or evaluation is necessary if the patient is asymptomatic

Correct Answer is D

Comment:

A urinalysis that is positive for blood should be followed up with a urine culture to evaluate for an asymptomatic urinary tract infection before further workup is done or referral to a urologist is made. Parabasal cells on a Pap smear indicate lack of estrogen, and are a normal finding in postmenopausal women. It requires no further evaluation.