Hematuria-nephrology Flashcards
Hematuria is defined by how many RBC?
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.)
What are the symptoms accompanied with hematuria?
Flank pain
Dysuria
Cloudy urine
Describe the morphology of RBC found in glomerulopathies
Dysmorphic RBC shape
What is the difference between glomerular and non-glomerular hemturia?
Glomerular: originate from glomerulonephritis or thin basement membrane disease
Non-glomerular: originate from kidney, ureter, bladder
Check p.5 in HEMATURIA
List the non-glomerular kidney hematuria etiologies?
“That’s a kidney RAPPP”
Pyelonephritis
Renal mass
Papillary necrosis
Polycystic kidney disease
Arteriovenous malformation
+
Nephrolithiasis
List the non-glomerular ureter hematuria etiologies?
Urolithiasis
Malignancies
Stricture
Polyp
List the non-glomerular bladder hematuria etiologies?
Bilharzia/schistosomiasis , TB caused Cystitis
Malignancy
Radiation
Which syndrome is characterized by the presence of hemoptysis and hematuria?
Good pasture syndrome
Differentiate painless vs painful hematuria?
Painful —>stones, infection
Painless—>malignancy
What are prostatic related etiologies for hematuria?
Senile prostatic enlargement
Tumor
Stones
Inflammatory condition
Which drugs cause the urine to turn red?
“FLR”
Furadantin(for UTI)
Laxative(like phenophthalein)
Rifampicin(for TB tx)
What are the risk factors for urologic diseases in hematura?
1-painless hematuria(malignancy until proven otherwise)
2-male(prostate cancer prevelancy), >40,smokers
3-hx of exposure to carcinogens
Deposition of which molecule is observed in nephropathy?
IgA deposition
Which test do you perform in case the urine dip stick showed high albumin levels?
24hr urine test
Which test do you perform in case the urine dip stick showed high leukocytes,nitrates, and erythrocytes levels?
Urine culture
What is the last diagnostic option for diagnosis of hematuria?
Cytoscopy—>biopsy
Where does edema occur in the morning vs afternoon in nephrotic syndrome?
Morning: eye edema
Afternoon: leg edema
Which tests are performed if hematuria specimen has dysmorphic RBC(suggestive of glomerular hematuria)?
Check:
Serum Cr
C3,C4(autoimmune disorders)
ASLO(Antistreptolysin O)
Serum Albumin
Urine protein/creatine ratio
Which tests are performed if hematuria specimen has normal shaped RBC(suggestive of non-glomerular hematuria)?
Urine culture
U/s and CT
Iv pyelogram
What is the hallmark for idiopathic nephrotic syndrome?
Effacement of podocyte foot processes
What is Tamm-horsfall proteins
The most abundant protein in urine
Protects the kidney from foreign damage
What is the normal levels of total protein and albumin excretion in pt with intact glomerulus?
<150mg/day total proteins
<30mg/day albumin
What is the nephrotic range of proteinuria ?
> 3.5g/day
What is the nephritic range of proteinuria ?
<3.5g/day
What are the 3 classifications of proteinuria?
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
What is used for screening(1st step) for detecting proteinuria?
Dipstick urine test(detects mainly albumin for proteins and other molecules )
Name a more efficient test than 24hr urine test?
Spot test
