Haematuria

Question 1

What is haematuria?

Answer 1

=Passage of
> 3 RBCs/ High Power Field
on urine microscopy

Question 2

What is Microscopic Haematuria?

Answer 2

• It is incidental finding at routine medical exam.

- Dipstick screening should be confirmed by microscopy , >3 RBCs/ HPF

Question 3

What is Macroscopic Haematuria?

Answer 3

-It is visible to the naked eyes.

-The urine will be dark,
rose-discolouration,
clots may be present.

• Beware of food and medication causing discolouration.
• Do a dipsticks to see that it is blood

Question 4

What is initial haematuria?

Answer 4

-It is when blood is visible at the beginning of micturition,
and then clears.

-Origin of initial haematuria will be the urethra

Question 5

What is terminal haematuria?

Answer 5

• It is when blood is seen at the end of micturition.

- The origin will be prostate/bladder

Question 6

What is terminal haematuria a classical presentation of?

Answer 6

-Schistosomiasis (Bilharzia)

Question 7

What is total haematuria?

Answer 7

• Blood is visible throughout micturition.

- The origin is upper tracts or bladder.

Question 8

What are the causes of haematuria?

Answer 8

1. Nephrological
2. Urological
3. Haematological

Question 9

What are the characteristics of nephrological haematuria?

Answer 9

• There will be 2/3 + protienuria on dipstick.
• The red blood cells will be dysmorphic.
• There might be red cell casts on microscopy.

Question 10

Name examples of nephrological causes of haematuria:

Answer 10

• Glomerulonephritis

- IgA nephropathy

Question 11

What are the characteristics of haematological and urological haematuria?

Answer 11

• No proteinuria
• Normal RBCs
• No red cell casts

Question 12

What can contribute to haematological haematuria:

Answer 12

• Warfarin

- Blood dyscrasias

Question 13

What does white cell casts mean:

Answer 13

-It may mean acute pyelonephritis

Question 14

Where can urological causes of haematuria arise from?

Answer 14

From the:

• Kidneys
• Ureter
• Bladder
• Prostate

Question 15

What to kidneys or from kidneys can cause haematuria?

Answer 15

1. Trauma (Blunt/Penetrating)
   - Beware of minor trauma

-Uretopelvic Junction (UPJ) can cause hydronephrosis.

2. Infection
   - Acute Pyelonephritis
   - TB
   - Schistomiasis
3. Renal Tumour
   - Malignant/ Benign
4. Renal stone
5. Polycystic Kidney Disease
6. Vascular Cuase
   - Renal Vein Thrombosis
   - Arterio-Venous fistula.

Question 16

What are the ureter causes of haematuria?

Answer 16

• Stone

- Tumour

Question 17

What are the bladder causes of haematuria?

Answer 17

1.Trauma
(Blunt/Penetrating)

2. Infections
   - TB
   - Schistomiasis
   - Acute haemorrhagic cystitis
3. Malignancy
   -Bladder Cancer
   *Commonest cause of
   Painless,
   Macroscopic
   Haematuria in
   older patients

Risk factor for bladder Cancer= Smoking

4. Bladder Calculus
   - Bladder outlet obstruction
   - Foreign Body
   - Neuropathic

Question 18

What are the Prostate causes of haematuria?

Answer 18

• BPH

- Carcinoma.

Question 19

What are the urethral causes of haematuria?

Answer 19

• Trauma

- Carcinoma

Question 20

What are the risk factors for Bladder Cancer?

Answer 20

-Smoking

• Occupational
• Aromatic Amine exposure
• Rubber Industry
• Truck Drivers

-Drugs

• UTI
• Schistososma infection