2: Peds Hematuria Flashcards
How does the hematuria usually present for this condition?
Trauma
Persistent macroscopic
If the urine culture is negative when hematuria is present, what other tests can be done (7)?
Renal or bladder ultrasound to assess for functionality or tumor Full CBC Electrolytes/BUN/creatinine Sickle-cell screen Complement C3 and C4 ANA Antistreptolysin O titre (ASO)
How does the hematuria usually present for this condition?
Hemoglobinopathy
Persistent macroscopic
Blood in the urine visible only on spun urine or dipstick.
Microscopic hematuria
High amounts of visible blood in the urine.
Gross hematuria
How does the hematuria usually present for this condition?
Benign recurrent hematuria
Intermittent/recurrent macroscopic
WITH or WITHOUT
persistent microscopic
Idiopathic hypercalciuria is indicated if urine calcium/creatinine ratio is ____.
> 0.18 or 0.21
Encourage fluids while referring to nephrology. Get US if stones suspected. Monitor BP.
What is the definition of TRUE hematuria?
RBCs visible on spun urine, not just dipstick.
Urine that is tea colored indicates what?
Blood that is older.
How does the hematuria usually present for this condition?
Renal or lower urinary tract stones
Persistent macroscopic
What is management for persistent hematuria without casts or protein?
Consider renal US or VCUG.
If protein is present, _____ is likely and rapid evaluation and referral to nephrology are needed.
nephritis
Which conditions usually present with intermittent/recurrent macroscopic hematuria OR intermittent/recurrent macroscopic with persistent microscopic hematuria (3)?
Immunoglobulin A nephropathy
Hypercalciuria
Benign recurrent hematuria
How does the hematuria usually present for this condition?
Glomerulonephritis
Persistent macroscopic
T/F Transient and benign microscopic hematuria in many patients does not require further workup.
False. Transient and benign microscopic hematuria in many patients REQUIRES further workup.
T/F Exercise can cause hematuria.
True. It’s not a common DDx though.
Urine that is bright red indicates what?
Blood that is newer.
Patient has >1+ heme on a dip. What would you do next?
Microscopy to evaluate for RBCs vs hemoglobinuria vs myoglobinuria.
When can you go back to annual UA screenings after hematuria?
Need a full 6 months of regular rescreens that are negative.
Which conditions usually present with persistent macroscopic hematuria (5)?
UTI Glomerulonephritis Hemoglobinopathy Trauma Renal or lower urinary tract stones
How does the hematuria usually present for this condition?
Hypercalciuria
Intermittent/recurrent macroscopic
WITH or WITHOUT
persistent microscopic
To further evaluate hematuria, what can be done (3)?
Immune workup
Three first morning urines over 1-2 weeks
Refer to urology or nephrology
How does the hematuria usually present for this condition?
Immunoglobulin A nephropathy
Intermittent/recurrent macroscopic
WITH or WITHOUT
persistent microscopic
What are 2 common causes of false positives for hematuria?
Irritation
Menses
If there is transient hematuria, what is the plan of care?
Repeat UA annually with BP and growth parameters.
DDx of hematuria (9).
UTI Trauma/irritation Glomerulonephritis Coagulopathy Hemoglobinopathy Stones Hydronephrosis Tumor Epididymitis
Odd DDx:
Vulvovaginitis, menstruation, etc.
Gynecological irriation
What virus may cause hematuria?
Adenovirus
Odd DDx:
Bleeding disorder outside kidneys that can cause hematuria.
Extrarenal hematuria
How does the hematuria usually present for this condition?
UTI
Persistent macroscopic
True blood in the urine.
Hematuria
Blood in the urine visible to the naked eye.
Macroscopic hematuria
