Haematuria Flashcards
Haematuria is regarded as a symptom of malignancy until proven otherwise. TRUE/FALSE?
TRUE
Aside from the urethra, where else can blood in the urine come from?
Haematospermia (blood in semen)
Vaginal bleeding
What usually causes haematospermia?
prostate cancer invading the seminal ducts
What are the different types of haematuria?
Visible
Or
Non-visible
- Asymptomatic
- Symptomatic
What methods are used to pick up non-visible haematuria?
Dipstick
Microscopy
What qualifies as non-visible haematuria on microscopy?
3 or more RBCs per high-power field on microscopy
in 2-3 urine specimens
What should you ask about in a history for haematuria?
- Smoking
- Occupational exposures (chemicals, dyes, rubber)
- Any gross haematuria in the past
- Age >40
- Specific drug abuse
Visible haematuria is a larger indicator of potential cancer than non-visible haematuria. TRUE/FALSE?
TRUE
What type of cancer is most commonly associated with haematuria?
Bladder cancer
Why do inflammatory changes in the urinary tract lead to haematuria?
Increase blood flow to the organ
Give examples of inflammatory conditions which would cause haematuria?
Urethritis Prostatitis Cystitis Ureteritis Pyelonephritis Glomerulonephritis
Patients who are passing renal or urinary stones experience haematuria. TRUE/FALSE?
FALSE
not all experience haematuria
What percentage of patients with renal cell cancer present with haematuria?
50-60%
usually at advanced stages of cancer
What do you call bleeding around the kidney, secondary to trauma?
peri-renal haematoma
What sports are known to cause haematuria?
Contact sports (trauma) Jogging (long distance - many develop haematuria which goes away after 1 week)
Why should a bladder not be immediately drained with a catheter if a patient is in urinary retention?
Decompression of bladder can cause haematuria
What blood thinning medications can be responsible for haematuria?
Warfarin
Heparin
Aspirin
What other cause of haematuria is related to the blood itself?
Bleeding disorders
What other substances can change urine colour and make patients suspect there is blood in their urine?
Myoglobin (e.g. in rhabdomyolosis)
Food/drugs (e.g. beetroot etc)
What condition can mimic haematuria in very young children?
“red diaper syndrome” caused by Serratia marcescens
- causes red discolouration similar to that seen in haematuria
What neoplasm is most likely to cause haematuria in children?
Nephroblastoma (20% have frank haematuria)
Other than renal calculi, what can be responsible for loin to groin pain?
Blood clots
A simple US works to see the bladder, especially when full. TRUE/FALSE?
TRUE
On what type of imagine can the collecting system not be viewed clearly, and how do we combat this?
CT imaging
=> we use contrast (Urogram)
What other investigations can be used to view the bladder?
cystoscopy
Invasive investigation of the ureters and kidneys must be done under general anaesthetic. TRUE/FALSE?
TRUE