Diagnosis Flashcards
cytology role
screening
diagnosis missed cis negative cystoscopy and ctu
follow up intm risk reduce cystoscopy, detect earlier stage
follow up high risk early and reduce missed tumours
when to do CTU
EAU: Once a bladder tumour has been detected, perform a CT urography in selected cases (e.g.,
tumours located in the trigone, multiple- or high-risk tumours).
NICE:Consider CT or MRI staging before transurethral resection of bladder tumour (TURBT) if muscle-invasive bladder cancer is suspected at cystoscopy
when to do pet
MIBC or high risk NMIBC before radical treatment
If indeterminate findings on CRT or MRI
Or high risk of met disease eg T3b
NICE
risk UTUC
5% will have metachronous upper tract TCC
diag accuracy ct for utuc
Pooled sensitivity of CTU for UTUC of 92% and specificity of 95%
urinary markers
Sensitivity is usually higher at the cost of lower specificity.
• Benign conditions and BCG influence many urinary marker tests.
• Requirements for sensitivity and specificity of a urinary marker test depend on the clinical context of the patient (screening, primary detection, follow up [high risk, low-/intermediate-risk]) .
definition haematuria
more than 3 RBC per high powered field
relation dipstick and rbc per HPF
1-10 is +
10-40 is ++
40-100 is +++
relation dipstick and rbc per HPF
1-10 is +
10-40 is ++
40-100 is +++
nephrological referral
Declining GFR by >10ml/min within last 5 years or >5ml/min within the last year
Stage 4 or 5 CKD
Significant proteinuria ACR> 30
referral for glomerunephritis
Under 40
Significant proteinuai ACR >30mg/mmol
Hypertension >140/90
eGFR <60
glomerular causes haematuria
non glomerular causes
IGA nephropathy Alports syndrome Goodpastures nephrotic HSP
non glomerular causes
papillary necrosis
interstitial nephritis
RAS
