Hematuria Flashcards
Hematuria is defined as
the presence of blood in the urine
what type of hematuria is visible to the naked eye
Gross hematuria
What type of hematuria is only detectible by examination of the urine sediment by microscopy, or urinalysis
Microscopic hematuria
True/false
Only microscopic hematuria requires evaluation
False
Both microscopic and gross needs evaluation
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 _%
10%
a) 40%
b) 20%
c) 10%
d) 5%
Microscopic hematuria in the male is most commonly from what?
benign prostatic hyperplasia
The lower tract source (bladder and urethra) of gross hematuria (in the absence of infection) is most commonly from what?
urothelial carcinoma of the bladder
Type of Gross hematuria
The presence of blood at the beginning of the urinary stream that clears during the stream.
This implies what?
Initial hematuria an anterior (penile) urethral source.
Type of Gross hematuria
The presence of blood at the end of the urinary stream.
This applies what?
Terminal hematuria,
a bladder neck or prostatic urethral source
Type of Gross hematuria
The presence of blood throughout the urinary stream
This implies what?
Total hematuria,
a bladder or upper tract source
Hematuria associated with renal colic suggests what?
ureteral stone
Irritative voiding symptoms in a young woman may suggest
acute bacterial infection and associated cystitis.
In the absence of other symptoms, gross hematuria may be more indicative of…..
tumor
Proteinuria and casts suggest origin from where?
renal origin.
Irritative voiding symptoms, bacteriuria, and a positive urine culture in the female suggest what issue?
urinary tract infection
True/False
Follow-up urinalysis is important after treatment to ensure resolution of the hematuria
True
Labs to run for hematuria
(1) Urinalysis
(2) Urine culture
(3) BUN and Creatinine
Imaging for hematuria
CT scan of the upper tract without contrast
Cystoscopy- Indicated in patients with gross hematuria or those over 35 years with asymptomatic hematuria
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
Cystoscopy
What imaging is used to evaluate for:
1) Neoplasm of the kidney or ureter
2) Urolithiasis
3) Obstructive uropathy
4) Intrinsic kidney disease
CT scan of the upper tract without contrast
In the absence of infection or other benign etiology where would you refer your patients?
Urology
True/False
Treatment will be dependent on the underlying disease process
True
