This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Urology, Subject name: Surgery
[{'content': 'A 60 year old smoker came with the history of single episode of painless gross hematuria . Most logical investigation would be. \nSelect and explain. \nA. USG, B. X-ray KUB, C. Urine routine, D. Urine microscopy for malignant cytology cells', 'role': 'user'}, {'content': "Answer: D \nExplanation: REPEAT QUESTION. In this case, we should suspect bladder carcinoma ( transitional cell carcinoma ) . RISK FACTORS:- 1.Smoker :- component of tobacco - 4 aminobiphenyl. 2. Cyclophosphamide.(Phenacitin also) 3.Schistosomiasis in endemic regions . 4.Chemical (Aromatic hydrocarbon -Aniline). 5.Stones. 6.Radiation. 7.F.B. It is more common in males -3:1. They usually presents with painless gross hematuria. IOC :-Thus the best option here is urine microsopy for RBC's and malignant cells.urine cytology even though not a good screening test because of lack of sensitivity is highly specific . Mainstay of diagnosis is cystourethroscopy. investigations include imaging ( CT , MRI ,USG ,IVU ) and blood investigations for HB , electrolytes and urea . Gold std:- CYSTOSCOPY Bailey and Love 27th edition.chapter 77.pg no 1449.", 'role': 'assistant'}]