Haematuria Flashcards

1
Q

What is haematuria?

A

Presence of blood in the urine

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2
Q

What is the difference between visible and non visible haematuria?

A

Visible can be seen with the naked eye and non-visible is confirmed by urine dipstick or urine microscopy

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3
Q

What is pseudohaematuria?

A

Red or brown urine that is not secondary to the presence of haemoglobin, causes include medication, hyperbilirubinuria, myoglobinuria and certain foods

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4
Q

What can cause haematuria?

A

UTI, Urothelial carcinoma, stone disease, adenocarcinoma of the prostate, BPH, Trauma, radiation cystitis, parasite

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5
Q

What is the degree of haematuria?

A

Pink vs dark red and the presence of clots

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6
Q

What colours of urine would suggest a non-urological cause of haematuria?

A

Bright pink, orange or dark brown

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7
Q

What does the timing of the stream show in haematuria?

A

Total- bladder or upper tract source

Terminal- severe bladder irritation

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8
Q

What are the associated symptoms to ask about with haematuria?

A

LUTS
Fever, rigors
Suprapubic pain, flank pain, weight loss, trauma

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9
Q

What is smoking strongly associated to urologically?

A

malignancy

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10
Q

What increases risks of bladder cancer?

A

Industrial carcinogens

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11
Q

Why is foreign travel important with haematuria?

A

Schistosomiasis

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12
Q

What drugs can cause haematuria?

A

antiplatelets or antithrombotics

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13
Q

What examinations would you do for someone with haematuria?

A

Abdominal exam and a DRE and external genitalia

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14
Q

What investigations should you do for haematuria?

A

Urinalysis- nitrites or leukocytes may suggest UTI
Baseline bloods and PSA
Urinary protein levels (albumin:creatinine ratio or protein:creatinine ratio)

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15
Q

What is the urological referral criteria for someone over 45 with visible haematuria?

A

If unexplained without UTI or if persists or recurs after successful treatment or UTI

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16
Q

What is the urological referral criteria for anyone over 60 with unexplained non-visible haematuria?

A

dysuria or raised white cell count

17
Q

What are the specialist investigations if someone has haematuria?

A

Flexible cystoscopy is the gold standard
urine cytology
US KUB for nonviable haematuria
US Urogram for visible haematuria

18
Q

What percentage of people that have visible and non visible haematuria have malignancy?

A

20% who have visible haematuria

5% who have non-visible haematuria