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Urinalysis and Renal Disorders Flashcards

7 cards from real NRCME practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

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  1. A CMV driver is found to have orthostatic proteinuria. The appropriate NRCME action is:

    Answer: Certify normally; orthostatic proteinuria is a benign condition

    Orthostatic proteinuria is a benign condition in young individuals where protein appears in urine only in the upright position and carries no cardiovascular or renal risk.

  2. A driver's urine dipstick is positive for nitrites. This finding MOST specifically suggests:

    Answer: Gram-negative bacterial urinary tract infection

    Nitrites are produced by gram-negative bacteria that convert urinary nitrates to nitrites, making this finding highly specific for gram-negative UTI.

  3. Which medication commonly used by CMV drivers can cause FALSE-POSITIVE urine glucose on dipstick testing?

    Answer: High-dose vitamin C (ascorbic acid)

    High-dose vitamin C can interfere with the glucose oxidase reaction on dipstick, causing false-negative results for glucose (and false results for other analytes).

  4. A dialysis-dependent driver applies for a DOT medical certificate. Under FMCSA standards, this driver is:

    Answer: Disqualified from interstate commerce

    FMCSA regulations disqualify drivers who are on dialysis from operating CMVs in interstate commerce due to the unpredictability of uremic complications and treatment schedules.

  5. A urine dipstick shows bilirubin positive and urobilinogen elevated. This pattern is MOST consistent with:

    Answer: Hepatocellular disease (hepatitis/cirrhosis)

    Both conjugated bilirubin (filtered by kidneys) and urobilinogen are elevated in hepatocellular disease because the liver cannot clear urobilinogen reabsorbed from the gut.

  6. A driver with a solitary kidney (unilateral nephrectomy) should be evaluated PRIMARILY for:

    Answer: Compensatory hypertrophy adequacy, blood pressure control, and residual renal function

    The NRCME must assess whether the remaining kidney provides adequate function (eGFR), whether hypertension is well-controlled, and overall cardiovascular risk.

  7. When should a commercial driver with asymptomatic microscopic hematuria be referred for further urological evaluation before certification?

    Answer: When 3 or more RBCs per HPF are found on two separate properly collected specimens

    Persistent microscopic hematuria (≥3 RBCs/HPF on two specimens) warrants urological workup to exclude bladder cancer, kidney stones, or glomerular disease before certification.