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Urinary Symptoms and thirst > Blood in urine: Microscopic and macroscopic haematuria > Flashcards

Blood in urine: Microscopic and macroscopic haematuria Flashcards

1
Q

How is haematuria termed? 2

A

Non-glomerular

Glomerular

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2
Q

What are the chemicals and changes that happen when urine dipstick is used to test for blood? Positve colour?

A

tetramethylbenzidine reacts with heme to produce oxidised chromogen
Green-blue

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3
Q

Risk factors for kidney or urinary tract cancer

A
  • Age
  • Smoking
  • Exposures to benzene, aromatic amines (dyes, road fumes), carcinogens, chemotherapy (eg: cyclophosphamide), or high doses of analgesics
  • A history of:
  • Irritative voiding symptoms
  • Chronic urinary tract infection
  • Indwelling urinary catheter
  • Pelvic irradiation (radiotherapy)
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4
Q

Risk factors for kidney or urinary tract cancer

A
  • Age
  • Smoking
  • Exposures to benzene, aromatic amines (dyes, road fumes), carcinogens, chemotherapy (eg: cyclophosphamide), or high doses of analgesics
  • A history of:
  • Irritative voiding symptoms
  • Chronic urinary tract infection
  • Indwelling urinary catheter
  • Pelvic irradiation (radiotherapy)
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5
Q

What do muddy-brown casts in urine microscopy mean?

A

substance that has been stuck in the kidney tubules and then later flushed out in urine= kindney loss of functio

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6
Q

What is creatine kinase a marker for

A

Muscle damage inflammation

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7
Q

What is a good marker for Muscle damage inflammation

A

creatine kinase

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8
Q

What is rhabdomyolysis?

A

the breakdown of muscle tissue that leads to the release of muscle fiber contents into the blood

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9
Q

Risk factors for rhabdomyolysis

A

extreme exercise, crush injury, STATINS

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10
Q

What is treatment for rhabdomyolysis

A

promote diuresis with hydration, support for AKI (ie: dialysis)

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11
Q

What does blood urine look like for renal cancer ?

A

Bright red

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12
Q

How does rhabdomyolysis cause positive blood in urine

A

releases (among other things) myoglobin.
Normally bound to plasma protein – once binding capacity exceeded,
filtered at glomerulus, causes tubular obstruction, and myoglobinuria
(myoglobin contains heme subunit so reacts positively to dipstick
reagent)

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13
Q

How does Henoch-Schonlein purpura (HSP) present

A

Presents with haematuria (visible or non-visible,

glomerular haematuria), palpable purpuric rash

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14
Q

What is the diagnosis?
haematuria (visible or non-visible,
glomerular haematuria), palpable purpuric rash

A

Henoch-Schonlein purpura (HSP)

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15
Q

What causes the signs of Henoch-Schonlein purpura (HSP)

A

Caused by IgA deposits in vessels (kidney, skin), so

the glomerular component of HSP is IgA nephropathy.

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16
Q

What is the most common types of glomerulonephritis

A

IgA nephropathy

17
Q

What happns if someone is older than 35 and has haematuria?

A

Fulll tract incvestigation of cancer

18
Q

What typically presents as sudden onset left loin pain, radiating to her groin

A

Kidney stone

19
Q

What are risks of kidney stones?

A

— metabolic syndrome, heat (concentrated urine), thiazide

diuretics (increase calciuria)

20
Q

What is ANCA vasculitis?

A

Systemic disease caused by circulating antibody –Antineutrophil cytoplasmic antibody (ANCA)

21
Q

What does ANCA vasculitis cause?

A

systemic vasculitis and granulomatosis of multiple target
organs. Classically causes pulmonary-renal syndrome with rapidly
progressive kidney injury and lung injury

22
Q

What is the treatment for ANCA vasculitis?

A

immunosuppression (steroids/cyclophosphamide

or rituximab)

23
Q

How does ANCA vasculitis present

A

ANCA antibody positive Dramatic fall in kidney function
raised creatinine /urea)
vascular tunic looking rash
eyes look very inflamed and red

24
Q

How does ANCA vasculitis present on a biopsy?

A

Focal segmental necrotising GN with crescent formation

25
Q

What confirms a positve non-visible haematuria

A

NVH = either 2 positive urine dipsticks (out of 3 tests) OR >3 RBCs/HPF by microscopy

26
Q

What happens if there is it si not positive for blood in a red urine?

A

Look out for high protein -IgA nephropathy

Urinary Symptoms and thirst (4 decks)

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