How to interview a patient with blood in the urine
Other platforms explain it with text and video. In VMS you practice it on the patient.
Visible blood in the urine without pain needs a cancer work-up, especially in older adults and smokers.
Step by step
Introduce yourself and get consent
Ask the patient to describe the color. [1]
Visible or not
Seen by the patient, or found only on a urine test. [2]
Timing and clots
At the start, throughout, or at the end of the stream; clots; trouble passing urine. [2]
Pain
Colicky flank pain suggests a stone; burning suggests infection; painless raises concern for cancer. [3]
Risk factors
Smoking, older age, chemical exposure at work, past pelvic radiation. [3]
Other causes
Recent exercise, injury, menstruation, foods like beets, blood thinners. [3]
Summarize and plan
Explain urine tests, imaging and a bladder exam if needed. [1]
Common errors
- Blaming blood thinners without further tests.
- Not asking about smoking.
- Missing clots and retention.
Practice it in VMS
In VMS 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.
VMS cases that train this skill
Sources
- AAMC Core Entrustable Professional Activities (Core EPAs)
- NBOME COMLEX-USA clinical presentations
- NCCPA PANCE Content Blueprint
Facts and steps follow NBOME COMLEX-USA clinical presentations; NCCPA PANCE Content Blueprint; AAMC Core Entrustable Professional Activities (Core EPAs). VMS is not affiliated with these organizations. Updated: 2026-10-11.