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DT4-Exam 1 > Hematuria/Dysuria-Leah > Flashcards

Hematuria/Dysuria-Leah Flashcards

1
Q

Blood clots in urine are significant for?

A

LOWER urinary tract disease

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2
Q

When is it “normal” to see blood in urine?

A

Lady time

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3
Q

When urine is red/brown, should you be concerned about blood loss?

A
  • No –> color change usually doesn’t = large degree of blood loss
  • urinary tract usually not capable of causing significant blood loss
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4
Q

What defines “abnormal microscopic” hematuria?

What about in kids?

A

More than 2 RBCs/hpf, normally. 5 in kids.

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5
Q

Problem with dipstick testing of urine to detect hematuria?

A
  • frequent false POSITIVES, must do micro eval.

- False negatives aren’t a problems (sensitive test)

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6
Q

Three UA findings that suggest glomerular disease?

A
  • casts
  • proteinuria
  • dysmorphic cells

(remember, CLOTS rarely come from glomerulus*)

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7
Q

Causes of “isolated” (no renal insufficiency) + “transient” hematuria? (2)

A
  • post infectious GN

- exercise induced hematuria

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8
Q

Causes of isolated/ persistent hematuria? (3)

A

IgA, Alports, Thin Membrane Lesion

Suspect these if symptoms continue to reoccur over a years time with no kidney insufficiency

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9
Q

When does hematuria require immediate diagnosis?

A

-It doesn’t, you can repeat exam in a few days to determine persistence

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10
Q

Transient hematuria in patients 50+ should always make you consider?

A

malignancy

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11
Q

Cancers presenting w/ hematuria?

A

renal, bladder

rarely: prostate

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12
Q

What cancers can be detected by atypical cells on urine cytology?

A
  • bladder 90% of cases

- upper urinary tract: rarely detectable with cytology

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13
Q

Radiologic exam with the best sensitivity and specificity for masses/ cancers of GU system?
When should is be avoided?

A

CT urography

-cant use in pregnant women/kids/

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14
Q

Exam that should be done in all adults with unexplained hematuria?

A

Cystoscopy

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15
Q

Only test that visualizes urethra and prostate?

A

Cystoscopy

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16
Q

Patients who have normal micro/ radio exams but still have hematuria most likely have?

A

mild glomerulopathies or intermittent stones

17
Q

Which gender gets stones most often?
What kind of stones are most common?
Is the prevalence increasing or decreasing?

A

Male, calcium oxalate, increasing US prevalence (think ^ DM = ^ EDRD = ^PTH = ^stones)

18
Q

Alkaline urine is assc with what type of stones?

What is the most common cause of these s tones?

A

struvite –> urease + bugs like Klebsiella, Proteus

19
Q

Significant risk factor for recurrent stone formation?

A

Family history

20
Q

Gold standard for imaging of stones?

A

Non-contrast helical CT scan (in adults, not kids/preggos)
Nearly 100% specific
Use US in kids/ preggos

21
Q

When might an abdominal xray be used to dx stones?

A

-Prior history of radiopaque stones

can miss lucid stones/ other causes

22
Q

Why is IVP (intravenous pyelogram) no longer used to dx stones?

A

Lower sensitivity, higher radiation than CT

23
Q

Tx for kidney stones

A

pain meds, (opioids can be appropriate), fluids

May also give something to help stone pass (antispasmodic, CCB, etc)

24
Q

When should kidney stone “be removed”

aka when can’t it pass on its own?

A

> 10 mm in size, or if persists 4-6 weeks

patients w/ sepsis/ renal failure or other underlying disease may also need immediate removal

25
Q

What is a preventative measure that can be taken after any type of stone?

A

^^ fluid intake –> decrease concentration of urine

26
Q

Staghorn Calculus:
common in what sex?
cause?
symptoms?

A
  • common in females
  • caused by recurrent infection (clasically urease + bugs)
  • less pain than smaller stones (maybe just because its GIRLS WHO GET THEM AND WE ARE TOUGH!!)
27
Q

Isolated asymptomatic hematuria: common cause in kids

A

unknown, benign, common.
can re-evaluate/ followup without panicking
consider genetic renal disease after 1 year

28
Q

Thin basement membrane disease: inheritance pattern?

Alports: inheritance pattern? assc symptoms?

A

TBMD: AD
Alports: XR: cant see cant pee cant hear a bee!!

29
Q

PSGN: how long does it take for hematuria to resolve?

A

Hematuria resolves in 3-6 mos

30
Q

High urinary calcium/creatinine ratio causes what in kids?

A

-benign hematuria

31
Q

What is nutcracker syndrome?

A
  • left renal vein compression by aorta and s. mesenteric artery.
  • causes hematuria and proteinuria
32
Q

Hematuria is usually benign in kids. What if creatinine/ BUN are elevated?

A

–> be concerned about significant disease, further workup indicated (labs, imaging, etc)

33
Q

Three common causes of GROSS hematuria in kids?

A

UTI, meatus irritation, trauma

DT4-Exam 1 (17 decks)

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