Haematuria

Question 1

What are the upper urinary tract causes of haematuria?

Answer 1

o	Renal cancer
o	Upper tract urothelial cancer
o	Renal stones
o	UTI
o	Glomerular 
o	Renal trauma 
o	Enlarged kidneys

Question 2

What are the lower urinary tract causes of haematuria?

Answer 2

o	Bladder cancer 
o	Bladder stone
o	Prostate cancer
o	UTI
o	Radiation cystitis
o	Bladder/urethral trauma
o	Schistosomiasis

Question 3

What in the history would you ask about?

Answer 3

•	Colour of urine
•	Pain
      Colic or Dull ache
•	Fevers
•	Weight loss
•	Smoking
•	Occupation exposures (dyes)
•	Medications
      Aspirin
      NSAIDs
      Cyclophosphamide
•	Past Hx
      HTN
      TB
      Radiotherapy 
      Procedures
•	Family Hx
      Autosomal dominant PSK (ADPSK)
      Von Hippel Lindau (VHL)

Question 4

What is macroscopic/gross/frank haematuria?

Answer 4

Visible

Question 5

What is microscoic haematuria?

Answer 5

Found on dipstick/microscopy, >5 RBC per high power field

Question 6

Why would you do a MSU?

Answer 6

Rule out infection

Question 7

What should patients >45 with macroscopic haematuria in the absence of UTI be investigated with?

Answer 7

• Cystoscopy

- Upper tract imaging

Question 8

In patients <45 with microscopic haematuria, they only require urological investigation if…

Answer 8

• Increased urinary frequency

- Loin pain

Question 9

What else can cause red urine?

Answer 9

• Haemoglobin
• Myoglobin
• Beetroot
• Rifampicin
• Porphyrins

Question 10

How does IgA nephropathy most commonly present?

Answer 10

Macroscopic haematuria in young people 1-2 days following an upper respiratory tract infection

Question 11

What is IgA nephropathy associated with?

Answer 11

• Alcoholic cirrhosis
• HSP vasculitis
• Coeliac disease/dermatitis herpetiformis