haematuria

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Author:
cathy4xo
ID:
48646
Filename:
haematuria
Updated:
2010-11-10 01:39:45
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haematuria
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haematuria
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  1. Name 4 categories of causes of haematuria and give 2 examples each.
    • renal - glomerular: glomerulonephritis, SLE, malignant htn, infective endocarditis, vasculitides
    • renal - non-glomerular: RCC, metastases, PKD, renal tuberculosis, infarction
    • lower urinary tract: cystitis, caliculi, bladder cancer
    • prostate: hyperplasia, prostate cancer
  2. What is the classical triad of RCC (present in 10-20% of pts)?
    • Haematuria
    • Flank pain
    • Palpable abdo mass
    • Note: Autosomal dominant polycystic kidneys may present similarly
  3. Besides the classical triad, what are the other less common Sx for RCC?
    • Less common: weight loss, anaemia, fever, htn
    • Very rare: hepatic dysfunction, erythrocytosis, neuromyopathies
  4. Describe the morphology of RCC.
    • Haemorrhagic and necrotic mass lesion
    • Often develops at upper pole of kidney
    • Central necrosis within tumour
    • U/S appearance may resemble a cyst
    • Invasion into renal vein (blood spread)
  5. What are the cell types of bladder cancer?
    • Common: 90% are transitional cell ca
    • Uncommon: squamous, adenomcarcinoma
  6. What are 4 risk factors for bladder cancer?
    • Smoking
    • Exposure to aromatic amines
    • Infection by Schistosoma haematobium
    • Drugs: cyclophosphamide, phenacetin
    • Transitional cell ca at other sites e.g. ureter, renal pelvis
  7. Name 2 types of renal calculi (composition).
    • Ca oxalate + Ca phosphate (75%)
    • Mg ammonium phosphate + Ca phosphate (15%) - more likely to obstruct & form hydronephrosis
  8. Describe the interpretation of urinanalysis in haematuria.
    • Blood +ve and no RBC: consider haemoglobinuria, myoglobinuria
    • Proteinuria or red cell casts: glomerular diseases
    • Pyuria or leukocytes: UTI
    • Blood +ve (isolated): neoplasms, calculi
  9. Name 8 Ix used for haematuria.
    • Abdo x-ray /US - calculi
    • CT/MRI - renal and bladder tumours
    • Cytology - transitional cell ca
    • IV pyelography - outflow obstruction
    • Angiography - renal tumours
    • Cystoscopy - bladder/ureter lesions
    • Retrograde pyelography - bladder/ureter lesions
    • FNAB
    • Open biopsy
    • Uric acid and urinary Ca - calculi
  10. Which 3 anatomical sites are most likely for a calculi to obstruct? (narrow)
    • Pelvic-ureteric junction
    • Crossing of iliac vessels
    • Entry of bladder

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