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Patient interview

How to interview a patient with blood in the urine

Other platforms explain it with text and video. In Making Synapses you practice it on the patient.

MD / DOPA
Practice it in VR with Blocky

Visible blood in the urine without pain needs a cancer work-up, especially in older adults and smokers.

Step by step

  1. Introduce yourself and get consent

    Ask the patient to describe the color. [1]

  2. Visible or not

    Seen by the patient, or found only on a urine test. [2]

  3. Timing and clots

    At the start, throughout, or at the end of the stream; clots; trouble passing urine. [2]

  4. Pain

    Colicky flank pain suggests a stone; burning suggests infection; painless raises concern for cancer. [3]

  5. Risk factors

    Smoking, older age, chemical exposure at work, past pelvic radiation. [3]

  6. Other causes

    Recent exercise, injury, menstruation, foods like beets, blood thinners. [3]

  7. Summarize and plan

    Explain urine tests, imaging and a bladder exam if needed. [1]

Common errors

Practice it in Making Synapses

In Making Synapses you do this on the patient, not on paper: every step goes on the checklist with a score, and in Teach mode Blocky tells you what comes next.

Making Synapses cases that train this skill

Sources

  1. AAMC Core Entrustable Professional Activities (Core EPAs)
  2. NBOME COMLEX-USA clinical presentations
  3. NCCPA PANCE Content Blueprint

Facts and steps follow NBOME COMLEX-USA clinical presentations; NCCPA PANCE Content Blueprint; AAMC Core Entrustable Professional Activities (Core EPAs). Making Synapses is not affiliated with these organizations. Updated: 2026-10-11.