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Renal Week 3 2017/18 > 6: Haematuria > Flashcards

6: Haematuria Flashcards

1
Q

Haematuria is ___ ml of blood in 100ml of urine.

A

1+ ml

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2
Q

Which organs may haematuria be caused by?

A

Kidneys

Ureters

Bladder

Urethra

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3
Q

What are two types of bleeding related to haematuria in men and women?

A

Haematospermia

PV bleeding

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4
Q

Which disease can cause haematospermia?

A

Prostate cancer

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5
Q

What are the two types of haematuria?

A

Visible

Non-visible

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6
Q

What is another name for visible haematuria?

A

Frank haematuria

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7
Q

How may non-visible haematuria be detected?

A

Urinalysis

Urine microscopy

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8
Q

What is the definition of microscopic haematuria?

A

3+ RBCs in 3 different urine samples

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9
Q

The biggest concern re: cause of haematuria should be ___.

A

cancer

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10
Q

What are risk factors for bladder cancer?

A

Age > 40

PMX of renal/urological problems

Smoking

Exposure to dyes

Analgesia abuse

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11
Q

What can cause haematuria?

A

Inflammation

UTI

Renal calculi

Malignancy

Trauma

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12
Q

Why do tumours bleed?

A

Angiogenesis - crappy blood vessels which rupture easily

Invasion - damaging existing blood vessels

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13
Q

___ of the urinary tract often present with haematuria.

A

Tumours

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14
Q

What are other symptoms of renal/urological cancers apart from haematuria?

A

Loin pain or renal colic

Obstruction - frequency, hesitancy, urgency…

Fever, WL, fatigue, anorexia

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15
Q

Prostate cancer causes haemat___.

A

haematospermia

NOT haematuria

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16
Q

What therapy for prostate cancer can cause haematuria?

A

Radiotherapy

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17
Q

What ruptures the kidneys to cause haematuria?

A

Trauma

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18
Q

What types of sports can cause haematuria?

A

Long-distance running

Contact sports

19
Q

Why does heavy exercise cause haematuria?

A

Systemic sympathetic vasoconstriction may cause hypoxic damage to nephrons

Also: rhabdomyolysis of skeletal muscle

20
Q

Rapid ___ can cause haematuria.

A

catheterisation

or decathetisation

21
Q

What are some iatrogenic causes of haematuria?

A

Surgery

22
Q

Which cardiovascular drugs can cause haematuria?

A

Warfarin

Heparin

Aspirin

anti-coagulants

23
Q

What chemical, found in the urine following skeletal muscle trauma, may mimic haematuria?

A

Myoglobin

rhabdomyolysis

24
Q

What drug, used to treat TB, can cause orange urine?

A

Rifampicin

25
Q

Which clotting factors are inhibited by

a) warfarin
b) heparin
c) LMWH?

A

a) II, VII, IX and Xa

b) IX and Xa

c) Xa

26
Q

What symptoms suggest UTI?

A

Loin pain

Frequency

Urgency

Dysuria

Haematuria

Constitutional symptoms

27
Q

What renal disease does smoking increase your chances of?

A

Bladder cancer

28
Q

What does industrial exposure e.g dyes and rubber increase your risk of?

A

Bladder cancer

29
Q

Which parasitic infection increases your chance of renal cancers?

A

Schistosomiasis

don’t swim in Lake Malawi

30
Q

How is suspected schistosomiasis investigated?

A

Cystoscopy

31
Q

If a man’s haematuria is

a) initial
b) terminal
c) mixed

in the stream, where is it likely coming from?

A

a) Urethra

b) Prostate

c) Bladder

32
Q

Bruising in the perineum in a butterfly-shaped pattern suggests what?

A

Urethral trauma

33
Q

What origin of haematuria is suggested by

a) wormy
b) round clots?

A

a) Upper urinary tract

b) Bladder

34
Q

Loin pain radiating to the groin is suggestive of ___.

A

renal calculi

35
Q

How are the kidneys palpated?

A

Balloting

two hands, anterior firm over the lumbar area, posterior bouncing the kidneys up and down

36
Q

Where is the prostate gland found on PR exam?

A

Anterior

37
Q

How does the bladder feel on PR exam in an advanced bladder cancer?

A

Hard, irregular and immobile

38
Q

What causes of haematuria are suggested on urinalysis with

a) elevated leukocytes and nitrites
b) just haematuria?

A

a) UTI

b) Trauma, cancer, stones

39
Q

Which investigations are good for viewing the kidney’s

a) parenchyma
b) collecting system?

A

a) USS, MRI, CT

b) IV, CT, MRI urogram

40
Q

What might you see on urogram of the bladder in TCC?

A

Filling defect

contrast only reaches one side, other side is filled with tumour

41
Q

What investigation is used to actually view the bladder for tumours, stones etc. causing visible haematuria?

A

Cystoscopy

42
Q

What are the first line investigations for haematuria?

A

CT cystography

Cystoscopy

43
Q

All patients with (visible haematuria / symptomatic non-visible haematuria) over the age of 40 should be investigated.

A

both groups

44
Q

What criteria is required to investigate a patient with asymptomatic non-visible haematuria?

A

Age > 40

Renal Week 3 2017/18 (12 decks)

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