Final Surgar L1 Flashcards
What is Hematuria?
Hematuria is blood in urine
HEME = BLOOD
UREA = URINE
تعريف أوضح
Definition: is the present of more than 3-5 RBCs / HPF during the microscopic examination of urine
نقدر نشوف ال hematouria عن طريق شيئين
اما Microscopic hematuriaاو Gross hematuria
طيب اش الاختلافات
🍁In Microscopic:
Apparently normal in color
Often asymptomatic patient
Detected by dipstick test or microscopic exam
🍁 Gross hematuria(macroscopic):
Tea-colored, pink, or Red urine
Redsh or brownish discoloration of urine
Degree of hematuria does not correlate with seriousness of disease
بمعنى أن كمية الدم في البول لا تعكس بالضرورة شدة الحالة المرضية أو خطورتها. قد تكون الهيماتوريا بسيطة في حالات خطيرة أو شديدة في حالات أقل خطورة.
🎯افتكر المثال اللي قاله الدكتور
Microscopic Hematuria we can consider it as a Sign rather than a symptom.
Why
لان المريض لما نسوي له فحص بالمايكروسكوب ونكتشف انو عندو هيماتويريا غالبا يجي بدون اعراض
Asymptomatic
Microscopic Hematuria we can consider it as a Sign rather than a symptom.
Why
لان المريض لما نسوي له فحص بالمايكروسكوب ونكتشف انو عندو هيماتويريا غالبا يجي بدون اعراض
Asymptomatic
نفس الحاله اللي شرحها الدكتور
Microscopic Hematuria we can consider it as a Sign rather than a symptom.
Why
لان المريض لما نسوي له فحص بالمايكروسكوب ونكتشف انو عندو هيماتويريا غالبا يجي بدون اعراض
Asymptomatic
نفس الحاله اللي شرحها الدكتور
If we do screening for healthy population the Prevalence of microscopic hematouria is around
6.5%
around 4% of pationt with microscopic hematouria (which is asymptomatic )can be detected with
With malignancy
Common Causes of RED Urine:
True Hematuria
Hemoglobinuria/myoglobinuria Menstruations (contamination)
Beets and blackberries (Anthrocyanin)»>false discoloration of urine
Nitrofurantoin»_space;drug
Rifampin»drug
Phenothiazines (e.g., Compazine)
Phenolphthalein (in bowel evacuants)
How To distinguish between the causes of redsh urin
By either using Dipstick test OR Microscopic Exam
🎯 Dipstick test is sensitive to
the presents of heme اي هيم سواء كان موجود في المايكروقلوبينيوريا او الهيموفوببنويوريا
or
the present of actual Rbcs
🩸لو كان الهيم موجود حيكون positive dipstick ولو مو موجود nigative dipstick
-it does not distingush between if heme if heme is from
~Hematuria
~Hemoglobinuria
~myoglobinuria.
~Rbcs
طيب كيف نفرق?بال microscopic examination.
نقدر من خلاله نشوف بعيننا ونميز وجود الRbcs وهذا يعتبر ترو هيماتويرريا
إذا الdipstick نواتجه بوزتف او نقتف بدون معلومات إضافيه انو من فين الهيم ذا بس المايكروسكوب حيقول لنا من فين
🧡Negative dipstick indicates:
●No hematuria (discolored urine)may due to food discoloring urine
💚 Positive dipstick indicates:
●Hematuria ●Hemoglobinuria ●myoglobinuria.
🩵 Microscopic examination:
Distinguish hematuria from hemoglobinuria and myoglobinuria
Doing microscopic to identify the actual and true present of more than3-5Rbcs in urin sample
Causes of Hemoglobinuria and Myoglobinuria
- hemolytic anemias
- mismatched blood transfusion
- drugs and toxins (Pamaquin, snake bite, spider bite, etc) - paroxysmal nocturnal hemoglobinuria ↪️can lead to hemolysis of the blood
- freshwater drowning
- cardio-pulmonary bypass
- crush injuries/muscle trauma
- drug induced muscle injury>some muscular can lead to muscular distraction and present of heme or myoglobinuria
Causes of Hemoglobinuria and Myoglobinuria
- hemolytic anemias
- mismatched blood transfusion
- drugs and toxins (Pamaquin, snake bite, spider bite, etc) - paroxysmal nocturnal hemoglobinuria ↪️can lead to hemolysis of the blood
- freshwater drowning
- cardio-pulmonary bypass
- crush injuries/muscle trauma
- drug induced muscle injury>some muscular can lead to muscular distraction and present of heme or myoglobinuria
Identify the presence of blood in the urine by
Dipstick and conferred by microscopic examination
Causes of Hematuria(true blood in the urine)
Classified into:
🌈Urological causes:
➢ Tumors of UT can lead to Hematuria
➢ Stones disease
➢ UTIs
➢ BPH(benine prostatic hyperplasia)or enlargment of prostrate
➢ Trauma to the UT
➢ Schistosomiasi of the UT
🌈Nephrologic (Renal)causes:
Glumerular causes OR Non glumerular causes such as:
-Tubulointerstitial
-Renvascular
🌈Systemic causes:
➢ bleeding disorders
➢ Anticoagulation ↪️drugs lead to anticoagulant effect like antienfflomaitory or anticoagulants
Calcification of the causes of hematouria according to the ag
MCC (most common cause)
⚡️0-20 childhood > :glomerulonephritis(MCC),UTI,congenital anomalies of the UT
⚡️20-40 adult >UTI (MC)spicily in female , stone diseases (spicily in male),bladder tumor (more common in male)
⚡️46-60 In male: bladder tumor ,stone,UTI
In female: UTI(more common in female), stone , bladder tumor(less commonly)
⚡️60: in male: BPH,bladder tumors,UTI
In female: bladder tumors, UTI
