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16 Cards in this Set
- Front
- Back
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What defines hematuria
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presence of no more than 2 RBCs per high power field in a spun urine sediment”
there is no “safe” lower limit below which significant dz can be excluded |
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What can't RBC be higher than 2/hpf?
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Higher than 2 hpf is false negative
Less than 2 hpf is false positive |
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Recent hx indicating a specific diagnosis of PSGN or IgA nephropathy in a patient with hematuria
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Recent URTI
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Given a picture of RBCs with "mickey mouse" ears, what is the most likely cause?
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Mickey Mouse = dysmorphic RBCs
Dysmorphic RBCs = glomerular bleeding |
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In three tube test, what is collected in each tube?
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Tube 1 = first few mL of urine
Tube 2 = mid-stream sample Tube 3 = last few mL of urine |
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Hematuria mainly in first tube of 3-tube test indicates
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Urethral lesion (post-renal urine)
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Hematuria mainly in third tube of 3-tube test indicates
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lesion near bladder trigone (terminal hematuria)
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Equivalent degree of hematuria across all 3 tubes indicates
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renal, ureteric, and diffuse bladder lesions
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Hematuria pattern in 3-tube test indicative of renal lesion?
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equal distribution in all 3 tubes
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Bladder cancer risk factors that serve as an indication for cystoscopy
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Men > 50
Heavy phenacetin use heavy smoking Dye exposure (anilin) Cyclophosphamide Analgesic abuse |
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What should be done if you find a bladder cancer?
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check upper tracts for lesions in renal pelvis and ureter
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Another indication for cystoscopy
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infrequent patient with unexplained or intermittent gross hematuria
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Most serious disorder in patient with unexplained hematuria
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Undiagnosed urinarty tract carcinoma
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followup strategy for high risk patients with persistent idiopathic microscopic hematuria
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repeat ultrasound and cystoscopy at 1 year
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followup strategy for low risk patients with persistent idiopathic microscopic hematuria
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periodic UA and urine cytology
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screening for hematuria should not be done when
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there are no symptoms of urinary tract disease
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