Haematuria Flashcards
Timeframe
Duration
Onset
Progression
Timing (intermittent or continuous)
Haematuria
Quantify how much blood Thick frank blood or discoloured urine Any clots- increased risk of urinary retention Catheterised (always ask) Anaemia Sx
Systems review
General- FWARJCT (joint swelling- very good)
Urological
Storage- frequency, volume
Infection- dysuria, odour
Prostatic or voiding- hesitancy, poor flow, dribbling, feeling of incomplete emptying, nocturia
Glomerulonephritis- sore throat recently
Others- trauma, abdominal pain, coughed any blood (vasculitides)
Renal cell carcinoma
Flank pain, haematuria, abdominal mass
Fever, HTN, weight loss
Excessive EPO production (polycythaemia)
Urethral Trauma
History of catheter use or trauma
UTI
Frequency, dysuria, urgency
Odour, cloudy, bloody
Confusion (delirium)
Fever, suprapubic pain
Urethritis
Dysuria
Purulent urethral discharge
Calculi
Acute onset Loin to groin pain, nausea and vomiting
Others
Prostate cancer/prostatitis Strenuous exercise Rhabdomyolysis Beetroot Coagulopathy (haemophilia) Urinary tract injury eg, catheterisation
Patients perspective
Feelings and effect on life
ICE
Background
PMH
DH
FH (anyone in family had this, bleeding disorders etc.)
SH- industrial chemicals or dyes
Transitional cell carcinoma
Painless intermittent haematuria
Bladder, ureters, urethra
Smoking and industrial dye work
Schistosomiasis is biggest cause of bladder cancer elsewhere (ask about foreign travel)
Glomerulonephritis
Nephritis (frank haematuria) or nephrotic syndrome
Many different causes- recent URTI (post strep, IgA nephropathy), haemoptysis (GOODPASTURES), systemic features eg. Rash suggests vasculitis
Investigations
May need 2 week wait referral
Urinalysis culture microscopy and sensitivities
UE FBC clotting profile autoantibody screen eg. ANCA, ANA
Cystoscopy, USS, CT KUB
May need renal biopsy (glomerulonephritis)
