Haematuria

Question 1

common cause of haematospermia?

Answer 1

prostate cancer

prostate enlargement

Question 2

lower urinary tract symptoms?

Answer 2

hesitancy
frequency
urgency
dysuria

Question 3

upper urinary tract symptoms?

Answer 3

renal colic

Question 4

what is significant microscopic haematuria?

Answer 4

3+ RBCs per high power field on microscopic evaluation of urine in two out of 3 samples

Question 5

risk factors?

Answer 5

analgesic abuse
exposure to chemicals or dyes
smoking
previous haematuria or urological disease

Question 6

which is more likely to be a cancer, visible or microscopic haematuria?

Answer 6

visible

Question 7

causes of haematuria?

Answer 7

benign (stones etc)
trauma
infection
malignancy

Question 8

infection where in the urinary tract can cause haematuria?

Answer 8

anywhere

Question 9

common presentations of renal cell cancer?

Answer 9

haematuria (50-60%)
pain (40%)
kidney mass (30-40%)
isreal triad (only present in <10%)

Question 10

urinary tract tumours presentation?

Answer 10

haematuria (75-85%)
loin pain/colic
voiding problems
urinary irritative symptoms

Question 11

which prostate conditions are more likely to cause haematuria?

Answer 11

BPH
post-radiation therapy (5-10 years after)
rarely causes by prostate cancer (<1%)

Question 12

penile cancer symptoms?

Answer 12

itching/burning under foreskin
red/indurated/lesioned area
haematuria???

Question 13

what is sport (joggers) haematuria?

Answer 13

renal/bladder trauma
can occur due to contact sports or in long distance runners
vasoconstriction of renal vessels
constriction of efferent arterioles
vascular responses to sports and trauma causing blood and muscle cell breakdown

Question 14

what is loin pain haematuria syndrome?

Answer 14

on and off episodes of loin pain on one side
together with pain, dysuria, vomiting and low grade fever but not associated with a UTI
can have normal or abnormal glomeruli

Question 15

what is decompression haematuria?

Answer 15

occurs when bladder is drained too quickly in urinary retention

Question 16

drugs causing haematuria?

Answer 16

warfarin
heparin
aspirin

Question 17

causes of deep pigmentation in urine?

Answer 17

menstrual
food (beetroot, blackberries, rhubarb
myoglobin in urine (rhabdomylolysis etc)
drugs (hydroxychloroquine, metronidazole, nitrofurantoin, laxitives)
toxins (lead, mercury)

Question 18

causes of frank haematuria in kids?

Answer 18

UTI
trauma
perineal irritation
sickle cell disease
nephrolithiasis
glomerulonephritis
malignancies

Question 19

what is red diaper syndrome?

Answer 19

serratia marcescens infection

Question 20

common kidney tumour in kids?

Answer 20

nephroblastoma

Question 21

features of UTI

Answer 21

loin pain
frequency
urgency
dysuria
feverish
shivering 
etc

Question 22

how can timing indicate source of bleeding

Answer 22

initial - urethra, prostate

terminal/total - bladder, upper urinary tract

Question 23

veriform clots?

Answer 23

worm-like clots which indicate upper urinary tract source of bleeding

Question 24

investigation of haematuria?

Answer 24

dipstick
culture (if infection suspected)
cytology
imaging
- MRI/CT/IV urogram to see collecting ducts
- US/CT/MRI scan to see internal kidney
- US/CT/MRI scan or IVU to see bladder

Question 25

what can CT show which indicates bladder cancer?

Answer 25

filling defects

Question 26

most sensitive test for bladder investigation?

Answer 26

cystoscopy or urethrocystoscopy

Question 27

who should be investigated?

Answer 27

> 45 yrs old with visible haematuria

>60 yrs with symptomatic non-visible haematuria

Question 28

who should be referred to urology?

Answer 28

all visible haematuria
symptomatic haematuria any age
asymptomatic haematuria >40 yrs old

Question 29

referral to nephrology

Answer 29

declining eGFR
significant proteinuria
isolated haematuria with hypertension