Hematuria Flashcards Preview

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Flashcards in Hematuria Deck (12):
1

Microscopic hematuria

>5 red blood cells/hpf

X3, obtained over several weeks

Urine not discolored

Normal in 2-3% of school-age children
Just repeat a UA with microscopy
Only 1% are still positive at 6 months follow up

2

If dipstick +blood, what is next step?

Get a UA with microscopy

Blood could be hemoglobin
Myoglobin
Porphyrins

3

Benign familial hematuria

Hematuria is usually microscopic

Monitor for hypertension and proteinuria

No treatment needed

4

Transient hematuria causes

Minor trauma
exercise
fever

5

Persistent microscopic hematuria

UA positive on repeat

1. Check urine Ca/Cr ratio
-if >0.25, check 24 hr Ca excretion. +hypercalciuria if >4 mg/day. Then need a renal US (r/o kidney stone)

-if <0.25, get other labs

Patient could have SS or sickle trait

6

When is cystoscopy indicated?

Never

7

What are urate crystals?

Newborn diaper will be pink/red
Normal UA
Not blood
No workup/treatment

8

Causes of gross hematuria

HEMATURIA

Henoch Schonlein Purpura, hereditary nephritis
Easy benign familial
Membranoproliferative
IgA nephropathy and Alport
Trauma
Ureteropelvic junction obstruction
Renal stones
post-Infectious (strep)
Abnl RBCs (SS)

9

Tea/Coke colored urine

Glomerular disease (upper urinary tract)

10

Bright red urine with clots

Lower urinary tract
-stone
-UPJ issue
-Wilma tumor
-cystic kidney disease

11

Kidney stones

In children, need a full metabolic work up

All need US/X-ray

Usually Ca stones
-RTA
-hyperparathyroidism
-hypercalcemia
-loop diuretics

12

Kidney stone treatment

If <5mm, usually passes on own

Percutaneous nephrolithotomy
Increase fluid intake
Restrict salt

Thiazides diuretic