Hematuria Flashcards
microscopic hematuria defined as?
3 or more RBCs per high-power field
should urinalysis be used as a screening tool for bladder cancer?
NO; not strong enough
what test is sufficient to warrant a referral for hematuria?
microscopy of urine sediment (dipstick must be followed up with this to confirm)
causes of false positive urine dipstick
cleansing agent contam, urine pH very high, myoglobin from rhabdo, semen
if suspect glomerular cause of hematuria, what should you do next?
check serum Cr and eGFR (low GFR is sign of nephrologic cause)
if GFR is less than 60, don’t use?
contrast
if GFR is less than 30, don’t use?
Gadolinium (severe allergic rxn)
common causes of gross hematuria
UTI, urologic ca, bladder ca, BPH, kidney stones
who is at increased risk of urologic ca?
age 35-50, smoking hx, gross hematuria, voiding sx, chemical or drug exposure (cyclophosph, analgesics, Danube river), pelvic radiation
urologic evaluation of hematuria based on eGFR
greater than 60 = CT urogram; 30-60 = MR urogram; <30 = non-contrast imaging + retro pyelogram
urine cytology NOT recommended for gross hematuria
FREEBIE
follow-up guidelines for a pt with hematuria and initial negative evaluation
annual urinalysis/microscopy for the next 2 years at least
why are acanthocytes more specific than dysmorphic RBCs?
urine pH and osm can cause dysmorphic RBCs
T/F: a single episode of hematuria is sufficient to warrant a referral.
true!
does anticoag therapy change evaluation of hematuria?
NO
