NRCME Urinalysis and Renal Disorders 4

Question 1

A CMV driver's urinalysis shows a specific gravity of 1.001. Which condition does this most likely indicate?

Accepted Answer

Diabetes insipidus or overhydration

Answer

A specific gravity of 1.001 indicates very dilute urine, consistent with diabetes insipidus or excessive fluid intake.

Question 2

Under FMCSA regulations, a driver with an eGFR of 45 mL/min/1.73m² (Stage 3b CKD) should be:

Accepted Answer

Referred for specialist evaluation before certification decision

Answer

Stage 3b CKD requires specialist evaluation to assess stability, risk of progression, and cardiovascular risk before the ME makes a certification decision.

Question 3

Which urinalysis finding is MOST associated with rhabdomyolysis in a commercial driver?

Accepted Answer

Myoglobinuria causing brown/tea-colored urine

Answer

Rhabdomyolysis releases myoglobin into the bloodstream, which is filtered by the kidneys producing brown or tea-colored urine on dipstick.

Question 4

A driver reports taking ibuprofen daily for back pain. What renal concern should the NRCME examiner prioritize?

Accepted Answer

NSAID-induced nephropathy causing declining eGFR

Answer

Chronic NSAID use can cause analgesic nephropathy and progressive decline in renal function that may disqualify the driver.

Question 5

On urinalysis, waxy casts are MOST indicative of:

Accepted Answer

Advanced chronic renal failure with slow urine flow

Answer

Waxy casts form from degenerated granular casts in tubules with very slow flow, indicating advanced chronic renal disease.

NRCME - National Registry of Certified Medical Examiners Practice Test

NRCME - National Registry of Certified Medical Examiners Practice Test

NRCME Urinalysis and Renal Disorders 4