Haematuria Flashcards

1
Q

What is haematuria?

A

The presence of blood in the urine

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2
Q

What are the possible causes of haematuria?

A
  • UTI
  • Glomerular pathology
  • Urinary tract stones
  • Trauma
  • Other renal pathology
  • Vascular causes
  • Haematological causes
  • Drug induced
  • Exercise induced
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3
Q

What glomerular pathology can cause haematuria?

A
  • Post-infectious glomerulonephritis
  • Henoch-Schonlein purpura
  • IgA nephropathy
  • SLE
  • Hereditary glomerular pathologies
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4
Q

What hereditary glomerular pathologies can cause haematuria?

A
  • Thin basement membrane

- Alport’s syndrome

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5
Q

What other renal pathologies can cause haematuria?

A
  • Renal tract tumour

- Polycystic kidney disease

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6
Q

What are the vascular causes of haematuria?

A
  • Renal vein thrombosis

- Arteritis

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7
Q

What are the haematological causes of haematuria?

A
  • Coagulopathy

- Sickle cell disease

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8
Q

What drugs can cause haematuria?

A

Cyclophosphamide

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9
Q

What questions should be asked when taking a history of haematuria?

A
  • Have they had any UTI symptoms?
  • Have they had any renal stone symptoms?
  • Have they had any symptoms of glomerular pathology?
  • Have they had any signs of coagulopathy?
  • Have they had any recent trauma?
  • Any family history?
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10
Q

What UTI symptoms should be asked about?

A
  • Fever
  • Frequency
  • Dysuria
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11
Q

What is a symptom of renal stones?

A

Colicky abdominal pain

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12
Q

What are some symptoms of glomerular pathology?

A
  • Sore throat

- Rashes

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13
Q

What is a sign of coagulopathy?

A

Easy bruising

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14
Q

What family history should be asked about?

A
  • Haematuria
  • Deafness
  • Sickle cell disease
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15
Q

What should be looked for on examination when a patient presents with haematuria?

A
  • Abnormal BP
  • Palpable mass on abdomen
  • Rashes on skin
  • Pain or swelling in joints
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16
Q

What urine tests should be performed?

A
  • MCS
  • Protein:creatinine ratio
  • Calcium:creatinine ratio
17
Q

What is suggestive of nephritis on MCS?

A

Casts

18
Q

What bloods should be performed?

A
  • U&E’s
  • FBC
  • Clotting
  • Complement - C3/4
  • ANA/anti-dsDNA
19
Q

When might a renal biopsy be indicated?

A
  • Significant persistent proteinuria
  • Recurrent macroscopic haematuria
  • Renal function is abnormal
  • Complement levels are persistently abnormal
20
Q

What additional tests can be performed if needed?

A
  • Renal tract USS

- Urinalysis of parents

21
Q

What are some other causes of red urine?

A
  • Haemoglobinuria/myoglobinuria
  • Foods e.g. beetroot
  • Rifampicin
  • Urate crystals
  • External source e.g. menstrual blood loss
22
Q

How is haematuria managed?

A
  • Treat any obvious cause
  • Refer to paediatric nephrology if complex
  • Monitor if no obvious cause or worrying symptoms and if no resolution in 6 months refer to nephrology