HEMATURIA

Question 1

Anatomyof a patient with Hematuria.

Answer 1

(1) Kidneys
(2) Ureters
(3) Bladder
(4) Urethra

Question 2

the presence of blood in the urine

Answer 2

Hematuria

Question 3

blood in the urine - visible to the naked eye

Answer 3

Gross hematuria

Question 4

blood in the urine- only detectible by examination of the urine sediment by microscopy, or urinalysis

Answer 4

Microscopic hematuria

Question 5

Which one requires further evaluation

Answer 5

Both

Question 6

The lower tract source (bladder and urethra) of gross hematuria (in the absence of infection) is most commonly from**

Answer 6

urothelial carcinoma of the bladder.

Question 7

Microscopic hematuria in the male is most commonly from**

Answer 7

benign prostatic hyperplasia.

Question 8

the presence of blood at the beginning of the urinary stream that clears during the stream, implies an anterior (penile) urethral source.**

Answer 8

Initial hematuria

Question 9

the presence of blood at the end of the urinary stream,

implies a bladder neck or prostatic urethral source**

Answer 9

Terminal hematuria

Question 10

the presence of blood throughout the urinary stream, implies a bladder or upper tract source**

Answer 10

Total hematuria

Question 11

Hematuria associated with renal colic suggests

Answer 11

ureteral stone.

Question 12

Irritative voiding symptoms in a young woman may suggest

Answer 12

1. acute bacterial infection

2. associated cystitis.

Question 13

If cultures are negative or hematuria persists after therapy, then what

Answer 13

further evaluation is warranted

Question 14

In the absence of other symptoms, gross hematuria may be more indicative of

Answer 14

tumor.

Question 15

Laboratory Findings
(1)Urinalysis
Proteinuria and casts suggest

Answer 15

renal origin.

Question 16

Laboratory Findings
(1)Urinalysis
Other findings

Answer 16

1. Irritative voiding symptoms, bacteriuria, and a positive urine culture in the female suggest urinary tract infection,

Question 17

What all labs do you order

Answer 17

(1) UA
(2) Urine Culture
(3) BUN and Creatinine

Question 18

Imaging

Answer 18

(1) CT scan of the upper tract without contrast

(2) Cystoscopy

Question 19

Whats the CT evaluating for

Answer 19

1) Neoplasm of the kidney or ureter
2) Urolithiasis
3) Obstructive uropathy
4) Intrinsic kidney disease

Question 20

Whats the cystoscopy evaluating for

Answer 20

1) Bladder or urethral neoplasm
2) Benign prostatic enlargement
3) Radiation or chemical cystitis

*Indicated in patients with gross hematuria or those over 35 years with asymptomatic hematuria

Question 21

Treatment

Answer 21

dependent on the underlying disease process

Question 22

Referral

Answer 22

(1) Urology

(a) In the absence of infection or other benign etiology

Question 23

An upper urinary tract source can be identified in __% of patients with gross hematuria**

Answer 23

10%