Haematuria Flashcards
What is haematuria
Blood in the urine
If a patient presents to GP with frank haematuria, what do they require
Urological review
When do we diagnose patients with haematuria
If there is the presence of 5 or more RBCs per high power filled in 3 consecutive centrifuged specimens obtained at least 1 week apart
What is microscopic haematuria
Non-visible blood
Picked up on dipstick
incidental and asymptomatic
Symptomatic patients with haematuria may present with what
Hesitancy frequency urgency or dysuria Upper UTI complaints Renal colic
What sort of things can cause urine to appear red
Menstrual bleeding
food (blackberries, beetroot, rhubarb)
Myoglobin (Rhabdomyolisis, McArdle syndrome, Bywaters syndrome
Drugs: Chloroquine, rifampicin, nitrofurantoin, senna containing
Toxins e.g. lead or mercury
What are some risk factors for microscopic haematuria
Smoking Occupational exposure to chemicals and dye History of ross haematuria History of irradiative voiding symptoms History of UTI Analgeisc abuse Urological disorder or disease
at what age are you more likely to develop microscopic haematuria
Over 40 years old
What can kidney stones do to the kidney
Scratch the mucosa and cause bleeding
How do bladder stones arise
secondary to infection
What are the common presenting complaints of a renal tumour
Haematuria
Pain
kidney mass
What tumour is visible outside the skin
Willm’s tumour in the kidney (children)
What are the 2 types of kidney cancer
Kidney paranchyma
Transitional cell cancer
What cells are problematic in kidney parenchyma
Renal cell cancer
What cells are responsible for transitional cell cancer
Lining of upper urinary tract
Why do we not drain urine quickly in those with urinary retention
It can cause decompression haematuria - breaking of the blood vessels
Why is sigmoidal diverticula important when speaking about renal problems
Sigmoidal diverticula can open and perforate into the bladder and cause inflammation of the bladder. This may result in signs and communications to the bladder
If a patient is passing a lot of debris on micturition, what does this indicate
A communication between the bladder and bowel
What sort of disorders may cause haematuria
History of bleeding disorders
Dark blood with thick clots suggests what
something has happened but is resolving
What does fresh blood suggest
Something is ongoing and happening at the moment
What does the presence of worm like clots make you think
The clots have formed in the ureter
Why is it important to ask about smoking
Urothelial cancer is the second leading cause of tobacco related cancer mortality.
What is an important question to ask about blood in the urine
Is it present in the whole void or just the beginning. The beginning suggests urethra or prostate
What occupational exposures are risks for developing cancer of GU tract
Dyes (hairdresser)
Oils industry
Rubber industry
What are some other risk factors for developing GU cancer
Aristolochia - a plant in China used in tea
Schistosoma - a bug found on land - causes inflammation/ infection of the bladder leading to SCC of bladder
Phenacetin - causes harm ot kidney - was banned - caused transitional cell cancer of the kidney
What imaging techniques do we use for the kidney
US
CT
MRI
What is the first line investigation for suspected kidney trauma
CT
