Diagnostic Logic Puzzle: 4+ Protein in Urine

Arrange the clinical steps in the correct sequence after a urine dipstick shows 4+ protein.

Scenario: A patient’s urine dipstick result shows 4+ protein. Choose and order the most appropriate next steps.

Click steps from the left to add them to the sequence.

Available Steps

Repeat the urine dipstick to confirm persistent proteinuria

Order a quantitative urine protein-to-creatinine ratio

Assess for features of nephrotic syndrome

Evaluate kidney function and basic labs

Refer to nephrology

Start high-dose steroids immediately

Ignore the result

Your Sequence (1 → 5)

Step 1

Step 2

Step 3

Step 4

Step 5