NRCME Urinalysis and Renal Disorders 1

Question 1

According to FMCSA regulations, which of the following is routinely checked during the DOT urinalysis as part of the commercial driver physical examination?

Accepted Answer

Sugar, albumin, and specific gravity

Answer

The DOT urinalysis per 49 CFR 391.43 requires testing for sugar (glucose), albumin (protein), and specific gravity as a basic dipstick screen.

Question 2

A CMV driver's urinalysis shows 2+ glucose. What is the most appropriate next step for the medical examiner?

Accepted Answer

Investigate further for diabetes mellitus before making a certification decision

Answer

Glycosuria requires further investigation for diabetes mellitus; glucose alone does not automatically disqualify a driver, but its underlying cause must be evaluated.

Question 3

What is the clinical significance of finding persistent proteinuria (albumin 2+ or greater) on a DOT urinalysis in a commercial driver?

Accepted Answer

It may signal underlying renal disease requiring further evaluation

Answer

Persistent proteinuria may indicate underlying chronic kidney disease or other renal pathology and requires further workup before certification.

Question 4

Which specific gravity range is considered within normal limits during a DOT physical urinalysis?

Accepted Answer

1.010–1.030

Answer

A specific gravity of 1.010–1.030 reflects normal urine concentration; values outside this range may indicate renal concentrating defects or over-hydration.

Question 5

A commercial driver undergoing a DOT physical has a urinalysis positive for blood (hematuria). What should the medical examiner do?

Accepted Answer

Investigate the cause of hematuria before making a certification decision

Answer

Hematuria must be investigated to rule out significant urologic or renal pathology before the examiner can make an appropriate certification decision.

NRCME - National Registry of Certified Medical Examiners Practice Test

NRCME - National Registry of Certified Medical Examiners Practice Test

NRCME Urinalysis and Renal Disorders 1