**Question:** Following trauma, a patient presents with a drop of blood at the tip of urinary meatus. He complains of inability to pass urine. Next step should be -

A. Obtain urine analysis
B. Perform a digital rectal examination
C. Obtain renal ultrasound
D. Perform an intravenous urogram

**Correct Answer:** **A. Obtain urine analysis**

**Core Concept:** In the context of a patient presenting with hematuria (blood in urine) and difficulty in passing urine after trauma, the appropriate next step involves assessing the cause and ruling out potential urinary tract pathology.

**Why the Correct Answer is Right:** Urine analysis is crucial in this scenario as it can provide valuable information about the presence of blood in urine (hematuria), as well as any potential urinary tract infections or other pathologies. It allows for the identification of any abnormalities that could be the cause of the patient's symptoms.

**Why Each Wrong Option is Incorrect:**

1. Performing a digital rectal examination (option B) is relevant in assessing the patient's rectal examination findings, unrelated to the patient's urinary symptoms.
2. Obtaining a renal ultrasound (option C) is important in assessing kidney function but is not directly related to the diagnosis of hematuria and difficulty in passing urine.
3. Performing an intravenous urogram (option D) is a test used to evaluate kidney function and urinary tract anatomy. While it can provide information about urinary tract anomalies, it is not the immediate next step when dealing with hematuria and urinary retention symptoms.

**Clinical Pearl:** In cases with hematuria and difficulty in passing urine after trauma, urine analysis should be the initial step to investigate the cause and rule out potential urinary tract pathology. This approach allows for the early detection and management of potential complications, such as urinary tract infections or kidney damage.