Monday hematuria

Question 1

hematuria definition in kids and adults

Answer 1

2 Red Blood Cells / High Power Field in adults

5 Red Blood Cells / High Power Field in children

Question 2

if you spin urine down and the supernatent is red but is negative for heme, what could it be

Answer 2

porphyria
phenazopyridine
beets (colon resorbs red pigment betalaine and you pee it out)

Question 3

pernicious anemia

Answer 3

destruction of intestinal parietal cells, no intrinsitc factor, no b12 absorption, megaloblastic anemia

Question 4

if you spin urine down and the supernatent is positive for heme, what could it be

Answer 4

myoglobinuria - plasma clear

hemoglobinuria - plasma red

Question 5

extraglomeular bleeding pearls

glomerular bleeding pearls

Color?
clots?
protein?
RBC shape?
casts?

Answer 5

Extraglomerular:

Color red or pink
Maybe clots
Proteinuria absent
RBCs normal
Casts absent

Glomerular:

Color red, smokey brown, or coca-cola
Clots absent
proteinuria present
RBCs dysmorphic
maybe RBC casts

Question 6

Most common causes of persistent microscopic hematuria in children

Answer 6

Glomerulopathies: IgA nephropathy; Alport’s syndrome (Hereditary nephritis); Thin basement membrane disease (Familial hematuria); Post-infectious glomerulonephritis;

Hypercalciuria: urine calcium/creat > 0.2

Nutcracker syndrome (left renal vein compression by the aorta and superior mesenteric artery

Question 7

etiology of urolithiasis

Answer 7

80% of stones are calcium

Oxalate > Phosphate

Remainder are uric acid, struvite, or cystine stones

Question 8

5 Risk factors for calcium stone formation

Answer 8

Increased calcium excretion (hypercalciuria)
Increased uric acid excretion (hyperuricosuria)
Reduced citrate excretion (hypocitraturia)
Low urine volume
Increased oxalate excretion