hematuria

Question 1

What is hematuria?

Answer 1

Presence of at least 5 red blood cells per high-power field (400x) in the urinary sediment.

Question 2

Difference between gross and microscopic hematuria?

Answer 2

Gross is visible to the naked eye; microscopic is only detectable via lab analysis.

Question 3

What is pseudohematuria?

Answer 3

Red or discolored urine not due to blood (e.g., food, medications, or vaginal bleeding).

Question 4

What is pigmentary hematuria?

Answer 4

Urine discoloration due to pigments like hemoglobin or myoglobin, not whole blood cells.

Question 5

What is urethrorrhagia?

Answer 5

Bleeding from the urethra, not classified as true hematuria.

Question 6

What is medical hematuria?

Answer 6

Hematuria due to systemic or medical causes such as coagulopathies or glomerulonephritis.

Question 7

What is urological hematuria?

Answer 7

Hematuria caused by pathology in kidneys, ureters, bladder, urethra, or prostate.

Question 8

What are pre-renal causes of hematuria?

Answer 8

Coagulopathies, hemoglobinopathies.

Question 9

What are renal causes of hematuria?

Answer 9

Glomerular diseases, tubular necrosis, papillary necrosis.

Question 10

What are common ureteral causes of hematuria?

Answer 10

Stones, tumors, infections, iatrogenic damage.

Question 11

Name two iatrogenic causes of hematuria.

Answer 11

Ureteroscopy, catheter trauma.

Question 12

How can nephrolithiasis cause hematuria?

Answer 12

Stones cause inflammation and mucosal injury leading to bleeding.

Question 13

What bladder conditions may cause hematuria?

Answer 13

Stones, carcinoma, cystitis, trauma.

Question 14

What is the effect of BPH on hematuria?

Answer 14

BPH may cause bladder vein rupture and hematuria.

Question 15

What prostate conditions can lead to hematuria?

Answer 15

BPH, prostatitis, prostate cancer.

Question 16

What are vascular anomalies that cause hematuria?

Answer 16

Polycystic kidney disease, arteriovenous malformations.

Question 17

Can trauma cause hematuria?

Answer 17

Yes, blunt or penetrating renal or urological trauma can cause hematuria.

Question 18

What is the first step in evaluating hematuria?

Answer 18

Detailed medical history and physical examination.

Question 19

What lab test is key in microhematuria?

Answer 19

Urinalysis with sediment examination.

Question 20

Why use urine cytology in hematuria workup?

Answer 20

To detect urothelial carcinoma.

Question 21

What does the three-glass test differentiate?

Answer 21

Helps localize bleeding to urethra, bladder, or kidneys.

Question 22

Which imaging test is essential for hematuria?

Answer 22

Ultrasound or CT-IVU depending on suspicion.

Question 23

What is the role of cystoscopy?

Answer 23

Direct visualization of bladder to identify bleeding sources.

Question 24

What does CT-IVU assess?

Answer 24

Ureter, renal pelvis, and parenchymal causes.

Question 25

What is the Giordano maneuver?

Answer 25

Test for kidney tenderness during physical exam.

Question 26

What does a digital rectal exam assess in hematuria?

Answer 26

Prostate size and abnormalities.

Question 27

Why check coagulation in hematuria?

Answer 27

To identify bleeding disorders as a cause.

Question 28

What urinary condition may mimic hematuria?

Answer 28

Food dyes, medications, or vaginal bleeding.

Question 29

What is initial management for clot retention?

Answer 29

Bladder irrigation and catheterization.

Question 30

When is transfusion needed in hematuria?

Answer 30

If hematuria causes hemodynamic instability or anemia.

Question 31

What is cystoclysis?

Answer 31

Bladder irrigation with a 3-way catheter.

Question 32

What is the goal of conservative treatment?

Answer 32

Restore hemodynamic stability and evacuate clots.

Question 33

When is embolization indicated?

Answer 33

For arterial bleeding post renal surgery or trauma.

Question 34

When is nephrectomy considered?

Answer 34

As a last resort when embolization fails in trauma.

Question 35

What is a severe complication of hematuria?

Answer 35

Hemorrhagic shock due to blood loss.

Question 36

What causes hematuria after TURP/TURB?

Answer 36

Inadequate coagulation or vessel damage.

Question 37

How is post-surgical bleeding treated?

Answer 37

Endoscopic coagulation or embolization.

Question 38

What is a pseudoaneurysm?

Answer 38

Arterial outpouching that can rupture and bleed post-op.

Question 39

How can radiotherapy cause hematuria?

Answer 39

By inducing hemorrhagic cystitis.

Question 40

What does 'cutting for the stone' refer to?

Answer 40

Historical surgery for bladder stones with high risk.

Question 41

Who were the 'cutters' in urology history?

Answer 41

Itinerant surgeons who performed lithotomy for stones.