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24 Cards in this Set
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- Back
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what are the causes of pseudohematuria |
Meds: Ibuprofen, nitrofurantoin, phenazopyridine, EX-Lax, Rifampin
Veg: rhubarb, beets, blackberries, paprika, food coloring Iodine Metabolites |
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what can cause a false positive dipstick?
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semen
alkaline urine perineal cleansing agents |
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what can cause a false negative dipstick test
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Vit C in large amounts
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how accurate is a dipstick test
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91% - 100% sensitive
neg dipstick = no abnormalities |
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what do you do if a dipstick comes back +
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confirm the diagnosis with microscopy
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what can cause a positive dipstick result
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hematuria
false positives hemaglobinuria (hemolysis) myoglobinuria (rhabdomyolysis) |
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what is the AUA's deffinition of hematuria
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> or = 3 RBC's/hpf on 2/3 urine specimines
but there is NO SAFE LOWER LIMIT |
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what is the most common cause of hematuria worldwide
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Shistosomiasis
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what are the causes of extrarenal hematuria
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Infection: cystitis, prostatitis, urethritis, epididymitis
Malignancy: Ureter, bladder, prostate Stones |
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what are the common findings for children with stones and how do you treat it
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FH
hypercalcuria/uricosuria Thiozide diuretics and restricted purine diet or antiuricosuric drugs (Allopurinol) |
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what are the nonglomerular, intrarenal causes of hematuria
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malignancy
papillary necrosis: Sickle cell Trauma vascular: infarct, thrombosis, malformation |
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what are the glomerular, intrarenal causes of hematuria
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primary:
Alport synd IgA nephropathy (bergers) Thin BM disease secondary: goodpastures Henoch-Schonlein porpura PSGN Lupus Wegners |
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what is the clinical presentation of hematuria that is glomerular in origin
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RBC casts
Dark, cola colored, urine Dysmorphic RBCs protienuria |
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what is the clinical presentation of hematuria caused by a nonglomerular source
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RBC clots
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how do you R/O a renal malignancy
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MDCTU + cystoscopy (#1 preferred for adults)
ultrasound is preferred for children |
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what are the clinical characteristics of glomerulonephritis
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hematuria
RBC casts proteinuria HTN Edema Oliguria renal failure flank or back pain |
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what is PSGN caused by
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immune complex deposition, post GABHS infection (skin or pharyngeal)
predominantly in children 2-12 10% of GABHS infections the damage is caused by neutrophil infiltration as they try to clean up the debris |
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how long does it take to develop PSGN
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1-3 weeks post pharyngeal infection
3-6 weeks post skin infection |
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what are the lab techniques used to diagnose PSGN
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ASO titer (90%+ with prior pharyngeal infect, 50%+ for skin infect)
Streptozyme Anti-DNase-B titer (Best test for plost skin infect) Elevated BUN and Creatinine Low C3, norm C4 |
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how do you treat PSGN
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self limiting, control the sympt:
mild HTN- low salt, protein, K+ diet Moderate to severe HTN- diet + loop diuretics and anti-HTN meds |
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what is Alports
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X-linked nephritis
FH= males c renal failure and deafness |
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what is thin BM disease
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benign familial hematuria
microscopic hematuria renal fxn is normal throughout life |
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what is goodpastures synd
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Anti-glomerular BM disease
glomerulonephritis, Pulmonary hemorrhage, anti-GBM Ab +ANCA aggressive c high mortality |
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What is IgA nephropathy
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IgA deposition in the glomerulus
most common cause of glomerularnephritis worldwide 80% have URT infections No FH compliment levels are normal onset is 5 days after Strep? infection |
