Question of the Week # 45

A 45 y/o woman presents to the Emergency room with complaints of severe flank pain and nausea. Patient’s past medical history reveals chronic smoking and occupational exposure to aniline dyes. Physical examination reveals mild right costo-vertebral angle tenderness. The patient is afebrile. Labarotory investigations reveal urine dipstick positive for blood but negative for leucoesterase and nitrite. Urinalysis reveals numerous RBCs per HPF. There are no RBC casts or WBC casts. Urine HCG is negative. The next step in managing this patient’s condition  is:

• A) Start intravenos antibiotic therapy


• B) Non Contrast CT scan


• C) Contrast enhanced CT Scan


• D) CT urogram and Cystoscopy


• E) Ultrasonography