Hematuria Flashcards
How do you distinguish between extraglomerular and glomerular hematuria using protein levels in the urine?
- extraglomerular = <500 mg/day
- glomerular = >500 mg/day
The results of the centrifuged urine shows a supernatant red. You perform a dipstick heme and it comes back negative. What are the 4 possible causes of this?
supernatant = means when you spin but the particles do not drop to the bottom.
- Beeturia
- Phenazopyridine (Pyridium)
- Porphyria
- Other (Rifampin)
What is the most common cause of hematuria in a patient <40 yo?
GU infection
How do you distinguish between extraglomerular and glomerular hematuria using color?
- extraglomerular = red or pink
- glomerular = red, brown, “coca-cola”
If a pregnant patient presents with gross hematuria and without visible clots what imaging study is recommended?
-renal and bladder u/s
If you are concerned for a bladder tumor what imaging study should you order?
cystoscopy
If a non-pregnant patient presents with gross hematuria and WITHOUT visible clots what imaging study is recommended? (2)
- CTU
- Cystoscopy
What is the imaging test of choice for hematuria?
Ultrasound
What is the best test to evaluate for bladder or ureteral cancer?
Cystoscopy
If a patient presents with gross hematuria and visible clots what should you do?
- Order a CTU w + w/o contrast
- Refer for urgent urology evaluation
If the patient is over 40 and presents with hematuria what 3 tests do you want to order?
- Cystoscopy
- IVP
- Urine cytology
What diagnostic test uses contrast dye and can lead to ATN.
IVP
The results of the centrifuged urine shows a supernatant red. What test should you do next?
Dipstick heme
What is the most common cause of microscopic hematuria?
BPH
The results of the centrifuged urine shows a supernatant red. You perform a dipstick heme and it comes back positive. You look at the plasma color next. What is the diagnosis if it comes back clear vs red?
- clear = myoglobinuria
- red = hemoglobinuria
