Hematuria Flashcards
Hematuria detected microscopically is what value
When there are 3 or more RBCs per high power field
Hematuria of glomerular cause presents as dysmorphic RBCs or red cell casts (essentially broken RBCs) why?
Due to them deformed as they pass through the glomerular capillaries
Urine with visible clots, indicate an origin of what?
Non-Glomerular
First step when greeted with a patient of visible hematuria?
Urine analysis and microscopy
How would we yk if the Urinalaysis and microscopy reveal a glomerular origin?
There would be Proteinuria or RBC casts.
What do we next if analysis reveals Glomerular hematuria?
Consult a nephrologist.
If non glomerular origin of hematuria, what do we do next
A microbiological culture of the urine
If the micro test is positive, what do we do
Repeat tests following treatment to confirm resolution
But what if the urine microbiology is negative?
CT urogram, and Renal Ultrasound have to be performed
First step when met with Microscopic hematuria?
Rule out benign causes
If microscopic hematuria is persistent, what do we do
Stratify patients according to Urothelial risk of cancer, from low to high. According to age, smoking, and the amount of RBCs per high power yield
What do we do for microscopic hematuria patients of Low risk of Urothelial cancer?
Repeat tests after 6 months
What do we for patients of microscopic hematuria of medium risk for Urothelial cancer
Renal US and Cystoscopy
What do we for patients of microscopic hematuria of high risk for Urothelial cancer
CT urogram and Cystoscopy
Management of a medical emergency, of Acute Clot Retention?
60cc/ML Toomey syringe.!
