American Board of Family Medicine (ABFM) Practice Exam 2025 - Free ABFM Practice Questions and Study Guide

Asymptomatic microscopic hematuria is characterized primarily by the identification of red blood cells (RBCs) in the urine without accompanying symptoms. The standard definition in clinical practice states that the presence of three or more RBCs per high power field (hpf) on microscopic examination of the urine sediment, observed in a properly collected urine sample, is indicative of this condition. This threshold is clinically relevant as it helps differentiate between benign transient hematuria and those that may warrant further investigation due to potential underlying pathology.

The other options are either too low or not specific enough to meet the diagnostic criteria for asymptomatic microscopic hematuria. For instance, finding one RBC per hpf may occur due to various factors, such as minor trauma, or it may not be detected at all. A dipstick positive for blood may indicate hematuria but doesn't quantify the degree, which is essential for diagnosis. Therefore, having a count of three or more RBCs per hpf provides a reliable marker for diagnostic purposes in asymptomatic patients.