haematuria

Question 1

what are the causes of transient of spurious non-visible haematuria?

Answer 1

UTI
menstruation
vigorous exercise- settles after 3 days
sexual intercourse

Question 2

what are the causes of persistent non-visible haematuria?

Answer 2

cancer- bladder, renal, prostate
stones
BPH
prostatitis
urethritis eg chlamydia
renal causes
- IgA nephropathy
- thin basement membrane disease
- alport’s syndrome

Question 3

what are spurious causes of visible haematuria- blood not present on dipstick?

Answer 3

food- beetroot, rhubarb
drugs- rifampicin, doxorubicin

Question 4

what is the definition of persistent non-visible haematuria?

Answer 4

+ blood present in 2 out of 3 samples tested 2-3 weeks apart

Question 5

what investigations are needed in persistent non-visible haematuria?

Answer 5

renal function
albumin:creatinine ACR or protein:creatinine ratio
blood pressure

Question 6

when should you arrange an urgent 2ww referral for someone with haematuria?

Answer 6

age 45 and up AND
- unexplained visible haematuria w/o UTI or
- visible haematuria that persists or recurs after successful treatment of UTI

age 60 and up AND
- unexplained non-visible haematuria
- and dysuria or raised wcc

Question 7

when should you arrange a non-urgent referral for someone with haematuria?

Answer 7

age 60 and up with recurrent or persistent unexpalined UTI

Question 8

what are the renal causes of haematuria?

Answer 8

congenital- PCK
trauma
infection- pyelonephritis
neoplasm
immune- GN, TIN (tubulointerstitial nephritis)

Question 9

what are extra-renal causes of haematuria?

Answer 9

trauma- stones, catheter
infection- cystitis, prostatitis, urethritis
neoplasm- bladder, prostate
bleeding diathesis
drugs- NSAIDs, fursemide, ciprofloxacin, cephalosporins (cefalaxin, cefazolin)

Question 10

what are causes of asymptomatic haematuria?

Answer 10

IgA nephropathy
thin basement membrane disease
alport’s syndrome