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Internal 2 > Hematuria-nephrology > Flashcards

Hematuria-nephrology Flashcards

1
Q

Hematuria is defined by how many RBC?

A

Hematuria is defined as the presence of 5 or more red blood cells (RBCs) (per high-power field in 3 of 3 consecutive centrifuged specimens obtained at least 1 week apart.)

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2
Q

What are the symptoms accompanied with hematuria?

A

Flank pain
Dysuria
Cloudy urine

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3
Q

Describe the morphology of RBC found in glomerulopathies

A

Dysmorphic RBC shape

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4
Q

What is the difference between glomerular and non-glomerular hemturia?

A

Glomerular: originate from glomerulonephritis or thin basement membrane disease

Non-glomerular: originate from kidney, ureter, bladder

Check p.5 in HEMATURIA

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5
Q

List the non-glomerular kidney hematuria etiologies?

A

“That’s a kidney RAPPP”
Pyelonephritis
Renal mass
Papillary necrosis
Polycystic kidney disease
Arteriovenous malformation
+
Nephrolithiasis

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6
Q

List the non-glomerular ureter hematuria etiologies?

A

Urolithiasis
Malignancies
Stricture
Polyp

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7
Q

List the non-glomerular bladder hematuria etiologies?

A

Bilharzia/schistosomiasis , TB caused Cystitis
Malignancy
Radiation

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8
Q

Which syndrome is characterized by the presence of hemoptysis and hematuria?

A

Good pasture syndrome

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9
Q

Differentiate painless vs painful hematuria?

A

Painful —>stones, infection
Painless—>malignancy

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10
Q

What are prostatic related etiologies for hematuria?

A

Senile prostatic enlargement
Tumor
Stones
Inflammatory condition

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11
Q

Which drugs cause the urine to turn red?

A

“FLR”
Furadantin(for UTI)
Laxative(like phenophthalein)
Rifampicin(for TB tx)

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12
Q

What are the risk factors for urologic diseases in hematura?

A

1-painless hematuria(malignancy until proven otherwise)
2-male(prostate cancer prevelancy), >40,smokers
3-hx of exposure to carcinogens

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13
Q

Deposition of which molecule is observed in nephropathy?

A

IgA deposition

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14
Q

Which test do you perform in case the urine dip stick showed high albumin levels?

A

24hr urine test

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15
Q

Which test do you perform in case the urine dip stick showed high leukocytes,nitrates, and erythrocytes levels?

A

Urine culture

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16
Q

What is the last diagnostic option for diagnosis of hematuria?

A

Cytoscopy—>biopsy

17
Q

Where does edema occur in the morning vs afternoon in nephrotic syndrome?

A

Morning: eye edema
Afternoon: leg edema

18
Q

Which tests are performed if hematuria specimen has dysmorphic RBC(suggestive of glomerular hematuria)?

A

Check:
Serum Cr
C3,C4(autoimmune disorders)
ASLO(Antistreptolysin O)
Serum Albumin
Urine protein/creatine ratio

19
Q

Which tests are performed if hematuria specimen has normal shaped RBC(suggestive of non-glomerular hematuria)?

A

Urine culture
U/s and CT
Iv pyelogram

20
Q

What is the hallmark for idiopathic nephrotic syndrome?

A

Effacement of podocyte foot processes

21
Q

What is Tamm-horsfall proteins

A

The most abundant protein in urine
Protects the kidney from foreign damage

22
Q

What is the normal levels of total protein and albumin excretion in pt with intact glomerulus?

A

<150mg/day total proteins
<30mg/day albumin

23
Q

What is the nephrotic range of proteinuria ?

A

> 3.5g/day

24
Q

What is the nephritic range of proteinuria ?

A

<3.5g/day

25
Q

What are the 3 classifications of proteinuria?

A

Glomerular proteinuriaL increaased filtration of proteins that exceeds the reabsorption capacity of tubules

Tubular proteinuria: inadequate reabsorption of filtered low molecular weight proteins

Overflow proteinuria: excessive systemic prod of proteins

26
Q

What is used for screening(1st step) for detecting proteinuria?

A

Dipstick urine test(detects mainly albumin for proteins and other molecules )

27
Q

Name a more efficient test than 24hr urine test?

A

Spot test

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