Haematuria Flashcards
What presentation would prompt an immediate referral?
A patient presenting with haemturia but no UTI symptoms. If have UTI symptoms then should be treated and followed up with a referral
What are the differentials for haematuria?
UTI BPH Urinary calculi Malignancy Trauma Inflammation e.g. goodpasture's Renal cysts Haematological disease
What investigations should be done for haematuria?
Urinanalysis is essential: -Culture and sensitivity urine -Cytology -Urinary album:creatinine ratio Bloods should include: -U and Es -FBC -eGFR -clotting screen Males >50 should have PSA Imaging: -upper tract USS, retrograde pyelography or MRI -CT urography usually investigtion of choice -Flexible cystoscopy
What are most types of bladder cancer?
Most are transitional cell carcinoma
What is the most common presenting complaint fo bladder cancer?
Painless visible haematuria
What is the main investigation for suspected bladder cancer?
There should be CT or MRI staging to rule out muscle invasive cancer
What is the management for bladder tumours?
For small tumours use transurethral resection of bladder cancer
Those with higher grade on histology intravsical chemotherapy may be offered
With worse disease prognosis radical cystectomy or radical chemotherapy is offered
What is the classic triad of symptoms in renal cell carcinoma?
Haematuria
Loin pain
Abdo mass
More commonly present with insidious development of weight loss, anaemia and fatigue
What investigations should be done for renal cell carcinoma?
Renal function should be normal if the other kidney is still functioning well
CT to look for spread
What is the management of renal cell cancer?
Surgery can be used for smaller tumours that havent spread either by partial or radical nephrectomy.
When there has been disease spread then can perform a nephrectomy alongside immunotherapy with IFN alpha
Receptor tyrosine kinase inhibitors have been shown to be more effective e.g. sunitinib
What is the main type and common cause of penile cancer?
Main type is squamous cell carcinoma and HPV is a causitive factor
How do patients with penile cancer typically present?
Most present with a lump, ulcer or erythematous lesion. There may also be inguinal lymphadonopathy.
What are the investigations for penile cancer?
Biopsy of the lesion alongside lymph node staging with fine needle aspiration
How is penile cancer managed?
Premalignant disease is treated with excisional biopsy combined with topical chemotherapy
For invasive disease excision with lymph node clearance is required
How does testicular cancer typically present?
Painless testicular lump, may be testicular/abdo pain
