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 yr old smoker came with a history of painless gross hematuria for one day. Most logical investigation would be \nSelect and explain. \nA. Urine routine, B. Plain X ray KUB, C. USG KUB, D. Urine microscopy for malignant cytology', 'role': 'user'}, {'content': "Answer: D \nExplanation: In this case, we should suspect bladder carcinoma ( transitional cell carcinoma ) . Smokers are at a higher risk of developing TCC.Other risk factors being chemical .industry workers in western countries and schistosomiasis in endemic regions . It is more common in males -3:1. They usually presents with painless gross hematuria. 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 . Bailey and Love 27th edition.chapter 77.pg no 1449.", 'role': 'assistant'}]