Haematuria

Question 1

What is haematuria

Answer 1

Blood in the urine

Question 2

If a patient presents to GP with frank haematuria, what do they require

Answer 2

Urological review

Question 3

When do we diagnose patients with haematuria

Answer 3

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

Question 4

What is microscopic haematuria

Answer 4

Non-visible blood
Picked up on dipstick
incidental and asymptomatic

Question 5

Symptomatic patients with haematuria may present with what

Answer 5

Hesitancy 
frequency 
urgency or dysuria 
Upper UTI complaints 
Renal colic

Question 6

What sort of things can cause urine to appear red

Answer 6

Menstrual bleeding
food (blackberries, beetroot, rhubarb)
Myoglobin (Rhabdomyolisis, McArdle syndrome, Bywaters syndrome
Drugs: Chloroquine, rifampicin, nitrofurantoin, senna containing
Toxins e.g. lead or mercury

Question 7

What are some risk factors for microscopic haematuria

Answer 7

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

Question 8

at what age are you more likely to develop microscopic haematuria

Answer 8

Over 40 years old

Question 9

What can kidney stones do to the kidney

Answer 9

Scratch the mucosa and cause bleeding

Question 10

How do bladder stones arise

Answer 10

secondary to infection

Question 11

What are the common presenting complaints of a renal tumour

Answer 11

Haematuria
Pain
kidney mass

Question 12

What tumour is visible outside the skin

Answer 12

Willm’s tumour in the kidney (children)

Question 13

What are the 2 types of kidney cancer

Answer 13

Kidney paranchyma

Transitional cell cancer

Question 14

What cells are problematic in kidney parenchyma

Answer 14

Renal cell cancer

Question 15

What cells are responsible for transitional cell cancer

Answer 15

Lining of upper urinary tract

Question 16

Why do we not drain urine quickly in those with urinary retention

Answer 16

It can cause decompression haematuria - breaking of the blood vessels

Question 17

Why is sigmoidal diverticula important when speaking about renal problems

Answer 17

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

Question 18

If a patient is passing a lot of debris on micturition, what does this indicate

Answer 18

A communication between the bladder and bowel

Question 19

What sort of disorders may cause haematuria

Answer 19

History of bleeding disorders

Question 20

Dark blood with thick clots suggests what

Answer 20

something has happened but is resolving

Question 21

What does fresh blood suggest

Answer 21

Something is ongoing and happening at the moment

Question 22

What does the presence of worm like clots make you think

Answer 22

The clots have formed in the ureter

Question 23

Why is it important to ask about smoking

Answer 23

Urothelial cancer is the second leading cause of tobacco related cancer mortality.

Question 24

What is an important question to ask about blood in the urine

Answer 24

Is it present in the whole void or just the beginning. The beginning suggests urethra or prostate

Question 25

What occupational exposures are risks for developing cancer of GU tract

Answer 25

Dyes (hairdresser)
Oils industry
Rubber industry

Question 26

What are some other risk factors for developing GU cancer

Answer 26

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

Question 27

What imaging techniques do we use for the kidney

Answer 27

US
CT
MRI

Question 28

What is the first line investigation for suspected kidney trauma

Answer 28

CT