Card Set Information
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
: hyperplasia, prostate cancer
What is the classical triad of RCC (present in 10-20% of pts)?
Palpable abdo mass
: Autosomal dominant polycystic kidneys may present similarly
Besides the classical triad, what are the other less common Sx for RCC?
: weight loss, anaemia, fever, htn
: hepatic dysfunction, erythrocytosis, neuromyopathies
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)
What are the cell types of bladder cancer?
: 90% are transitional cell ca
: squamous, adenomcarcinoma
What are 4 risk factors for bladder cancer?
Exposure to aromatic amines
: cyclophosphamide, phenacetin
Transitional cell ca at other sites e.g. ureter, renal pelvis
Name 2 types of renal calculi (composition).
Ca oxalate + Ca phosphate (75%)
Mg ammonium phosphate + Ca phosphate (15%) - more likely to obstruct & form hydronephrosis
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
Blood +ve (isolated)
: neoplasms, calculi
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
Uric acid and urinary Ca - calculi
Which 3 anatomical sites are most likely for a calculi to obstruct? (narrow)
Crossing of iliac vessels
Entry of bladder