Hematuria

Question 1

Hematuria is defined as

Answer 1

the presence of blood in the urine

Question 2

what type of hematuria is visible to the naked eye

Answer 2

Gross hematuria

Question 3

What type of hematuria is only detectible by examination of the urine sediment by microscopy, or urinalysis

Answer 3

Microscopic hematuria

Question 4

True/false

Only microscopic hematuria requires evaluation

Answer 4

False

Both microscopic and gross needs evaluation

Question 5

An upper urinary tract source (kidneys and ureters) can be identified in __% of patients with gross or microscopic hematuria.

(a) Stone disease accounts for __%,
(b) Medical kidney disease for __%,
(c) Renal cell carcinoma for __%,
(d) Urothelial cell carcinoma of the ureter or renal pelvis for _%

Answer 5

10%

a) 40%
b) 20%
c) 10%
d) 5%

Question 6

Microscopic hematuria in the male is most commonly from what?

Answer 6

benign prostatic hyperplasia

Question 7

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

Answer 7

urothelial carcinoma of the bladder

Question 8

Type of Gross hematuria
The presence of blood at the beginning of the urinary stream that clears during the stream.
This implies what?

Answer 8

Initial hematuria
an anterior (penile) urethral source.

Question 9

Type of Gross hematuria
The presence of blood at the end of the urinary stream.
This applies what?

Answer 9

Terminal hematuria,

a bladder neck or prostatic urethral source

Question 10

Type of Gross hematuria
The presence of blood throughout the urinary stream
This implies what?

Answer 10

Total hematuria,

a bladder or upper tract source

Question 11

Hematuria associated with renal colic suggests what?

Answer 11

ureteral stone

Question 12

Irritative voiding symptoms in a young woman may suggest

Answer 12

acute bacterial infection and associated cystitis.

Question 13

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

Answer 13

tumor

Question 14

Proteinuria and casts suggest origin from where?

Answer 14

renal origin.

Question 15

Irritative voiding symptoms, bacteriuria, and a positive urine culture in the female suggest what issue?

Answer 15

urinary tract infection

Question 16

True/False

Follow-up urinalysis is important after treatment to ensure resolution of the hematuria

Answer 16

True

Question 17

Labs to run for hematuria

Answer 17

(1) Urinalysis
(2) Urine culture
(3) BUN and Creatinine

Question 18

Imaging for hematuria

Answer 18

CT scan of the upper tract without contrast

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

Question 19

What imaging is Indicated in patients with gross hematuria or those over 35 years with asymptomatic hematuria

to evaluate for:

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

Answer 19

Cystoscopy

Question 20

What imaging is used to evaluate for:

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

Answer 20

CT scan of the upper tract without contrast

Question 21

In the absence of infection or other benign etiology where would you refer your patients?

Answer 21

Urology

Question 22

True/False

Treatment will be dependent on the underlying disease process

Answer 22

True