Hematuria Flashcards
(20 cards)
DDx of red color urine
Hematuria
Hemoglobinuria or myoglobinuria
Beet root or blackberries
Chronic lead and mercury poisoning
Rifampicin, phenazopyridine
Classification of hematuria
Macroscopic (gross)
Microscopic
Causes of hematuria
Non glomerular (urological)
Glomerular
Urological diseases causing hematuria
Stones
Infections
Trauma
Tumors
BPH
Foreign bodies
PCKD
Glomerular diseases causing hematuria
IgA nephropathy/ Berger disease
Thin glomerular basement membrane dz
Hereditary nephritis / Alport syndrome
Glomerular hematuria will have
Red cast
Proteinuria
Non glomerular hematuria
Reddish pink
Clot
Dipstick test for blood detects
Peroxidase activity of RBC
Positive blood in urine dipstick
Hematuria
Hemoglobinuria
Myoglobinuria
False positive/ contamination
False positive blood in urine dipstick due to
Alkaline urine PH>9
Semen in urine
Urine contaminated with soap
Contamination from non urinary source (hemorrhoids, vaginal bleeding
Positive blood on dipstick but no RBC in urinalysis
Myoglobinuria (rhabdomyolysis or myoglobinuria RF)
Hemoglobinuria caused by infections
Transfusion related reaction
Paroxysmal nocturnal Hemoglobinuria
Evaluate patient with hematuria
Age
Timing
Clots
Fever
Trauma
LUTS
Examination for hematuria
Vitals
Edema of face and limbs
Pallor
Cutaneous bleeding
Loin tenderness
DRE
A bruit over renal artery indicates
Vascular cause
Renal angle tenderness suggests
Pyelonephritis
Nephrolithiasis
Lab investigations
24 hour urinary protein
Urine culture
Urine cytology
Other labs
CBC
RFT
PSA
COAGULATION STUDIES
Imaging
US
IVU
CT
Endoscopic investigations
Cystourethroscopy
Ureterorenoscopy
Clot retention in EM
Insert 3 way catheter do bladder washout and bladder irrigation
