3 - Hematuria Flashcards
Gross hematuria with clots usually comes from what source?
lower urinary tract
What is the gold standard test for microscopic hematuria?
- urine sediment
What is the definition of hematuria from a urine sediment?
- 3+ RBCs/hpf
What are 3 common reasons of false positive dipsticks?
- semen in urine
- alkaline urine or oxidizing agents
- myoglobinuria/hemoglobinuria
It is important to have a repeat urine microscopy test in ___ weeks to ensure no hematuria.
6 weeks
*to make sure this patient does not have cancer
If you see gross hematuria with clots what imaging study should you order?
CT abdomen and pelvis
If you see gross hematuria without clots what do you suspect the source is?
kidneys
Concurrent pyuria and dysuria is consistent with what diagnosis?
UTI
unilateral flank pain and hematuria is consistent with what diagnosis?
nephrolithiasis
RBC casts, dysmorphic appearing RBCs, and brown cola colored urine is consistent with what type of bleeding?
glomerular bleeding
For neprholithiasis and hydronephrosis do you want a CT with or without contrast?
without!
For renal and urothelial abnormalities do you want to order a CT with or without contrast?
with!
What are the 4 contraindications for CT urography?
- young patients with negative non-con CT
- pregnant women
- decreased renal function
- allergic to contrast
For what patient would a retrograde pyelography be indicated?
a patient who is unable to have IV contrast d/t decreased kidney function
What is the only imaging modality to permit visualization of prostate and urethra?
- Cystoscopy
If a patient has one episode of hematuria and high risk for malignancy how often do they need an urinalysis?
yearly urinalysis for 2 years
if both come back negative = they are done
If a patient has persistent hematuria how often should they have an urinalysis?
yearly urinalysis
if persistent for 3-5 years, repeat initial urologic work up
What is the main indication for a renal biopsy?
presence of glomerular hematuria (casts, dysmorphic RBCs)
CT urography is recommended for patients with this condition.
unexplained hematuria
