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Ureterolithiasis — USMLE Step 3 MCQ

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EasyAmbulatory Medicine / Primary CareUreterolithiasisUSMLE Step 3

A 48-year-old man comes for follow-up after an urgent care visit for renal colic. CT showed a 4-mm distal ureteral stone with no hydronephrosis. Pain is controlled with naproxen, creatinine is normal, and he is afebrile. Which of the following is the most appropriate next step in management?

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Correct answer: D — Strain urine and use medical expulsive management with follow-up

A stable patient with a small distal ureteral stone can be managed conservatively with analgesia, urine straining, and follow-up.

Reference: AUA ureteral calculi guidance; USMLE Step 3 sample question style