Flank pain, Nausea & vomiting, and/or symptoms of a stone Order: Urinalysis Hematuria Imaging Strain urine and stone analysis If second stone, consider 24 hour urine . Hematuria can be called either gross or microscopic. Title: Author: Levana_S Last modified by: IDO Created Date: 12/1/2005 7:38:47 AM Document presentation format: - A free PowerPoint PPT presentation (displayed as a Flash slide show) on PowerShow.com - id: 6c147f-MzkwM It is defined as ≥5 red blood cells per high power field (HPF) on a centrifuged urine sample. •initial hematuria usually suggests urethral bleeding New substances are constantly being added to the content of SCs. Recognize serious causes of hematuria and proteinuria that warrant immediate referral. Gross hematuria on the. URL of Article. Hematuria can derive from the kidneys, ureters, bladder, prostate (in men), or urethra . 2. Differential Diagnosis of red urine • Hematuria • Hemoglobinuria/myoglobinuria • Anthrocyanin in beets and blackberries • Chronic lead and mercury poisoning • Phenolphthalein (in bowel evacuants) • Phenothiazines (e.g., Compazine) • Rifampin 10. • Hematuria observed only with tumor invasion of the collecting system • Mass often only palpated in a thin adult • IVC involvement - Lower extremity edema, ascites, Budd-Chiari . INTRODUCTION. Differential diagnosis of asymptomatic and symptomatic monoclonal gammopathies is the determinant for starting therapy. Sometimes, hematuria is microscopic, or can't be seen without the help of a microscope. SpPD KGH CONTENT Definition of hematuria Etiology Clinical feature Differential diagnosis Laboratory tests Accompanied symptoms DEFINITION More than three red blood cells are found in centrifuged urine per high-power field microscopy ( > 3 RBC/HP).. Normal urine: no red blood cell or less than three red blood cell According to the amount of RBC in the . Infectious causes of terminal hematuria include cystitis or urethritis related to bacterial, viral, or protozoal organisms. [Differential diagnosis of hematuria in childhood]. Actions. Hematuria Tintinalli s Chap. It is never a normal finding and has a range of urological and non-urological causes, both malignant and benign, which commonly require further investigation. Gross hematuria occurs when there is enough blood present in the urine that it is visible to the naked eye. Patients show persistent microscopic hematuria, often with intermittent macroscopic hematuria. other hand is rare in pregnancy. S D J Med, 18:20-29, 01 Jun 1965 Cited by: 0 . Diagnosis can be confirmed with CT scan, which will show most other potential items in the differential if the scan is negative for a stone. Include the Chief Complaint and summary on this slide for audience . Metastatic MCC, although rare, should be considered in the differentials, especially if the patient is elderly with a history of skin MCC. As little as 1 mL of blood can impart colour to 1 litre of urine. Common Differential Diagnoses and Potential Complications Table 3 Common Differential Diagnosis for Abdominal Pain Medical Condition Relevant Findings and Potential Complications Gastrointestinal Constipation Infrequent bowel evacuations, difficult or painful defecation, can see blood in stool from anal fissures, low fibre diet, high An uncommon cause of hematuria in children, occurring in 1:5000 to 1:10,000 individuals [47, 23], Alport syndrome is an inherited disorder of the basement membrane, exhibiting microscopic hematuria and occasionally recurrent gross hematuria, and eventually progressing to proteinuria and chronic kidney disease, as well as extrarenal . Common and important causes of painless hematuria for doctors and medical students This page is currently being written and will be available soon. In many such patients, particularly young adult patients, the hematuria is transient and of no consequence [].On the other hand, there is an appreciable risk of malignancy in older patients (eg, over age 35 years) with hematuria, even if transient []. RED EYE, a Differential Diagnosis - PowerPoint PPT Presentation. Can turn toilet water colour pale pink or bright red. AV malformations. Differential diagnosis of Hematuria R2 黃瑞昌 / Vs 朱柏齡副院長 2020-01-09 . Macroscopic hematuria is red or brown urine, sometimes with blood clots. Microscopic hematuria is a result of there being an amount of blood in the urine that can only be seen through a microscope. Differential Diagnosis of Hematuria Anatomy- renal cyst, AVM, hydronephrosis Boulders- renal stone, hypercalciuria Cancer- Wilm s tumor , adenocarcinoma - A free PowerPoint PPT presentation (displayed as a Flash slide show) on PowerShow.com - id: 4d44f4-ZDFmN As little as 1 mL of blood can impart color to 1 liter of urine. 4. . Figure 5. Visible (gross) hematuria is urine that is visibly discolored by blood or blood clot. Hematuria is defined as the presence of at least 5 red blood cells/HPF in 3 of 3 consecutive centrifuged specimens obtained at least 7 days apart. Differential diagnosis of red urine (it does not always need to be blood) o Haematuria Red blood cells in urine (macroscopic or microscopic) o Haemoglobinuria From haemolysis. Gross Hematuria: Diagnostic clues •Recent vigorous exercise or trauma. HEMATURIA SUBODH KUMAR SHAH Intern 9th batch. The common causes of hematuria are discussed and how to evaluate it and the differential diagnosis can be simplified with a systematic approach. The differential diagnoses for terminal hematuria include disorders in the posterior urethra, bladder neck, or trigone area and broadly include infectious and non-infectious etiology. Based on the laboratory tests, lupus nephritis (negative ANA and dsDNA) and C3 glomerulonephritis (normal complement . Microscopic . infection, followed by bladder stones, underlying renal disease, medications, trauma, tumors and obstruction [ 2 . (See the image. Many of these kindreds are carriers of autosomal recessive Alport syndrome. Hospital Pediatrics publishes original research on significant topics in the pediatric hospital medicine subspecialty. Hematuria is often first encountered by the primary care provider. The criteria for determining end-organ damage should include markers of organ injury caused by the monoclonal protein. Anticoagulation-associated hematuria is a reasonable differential diagnosis for this patient's hematuria. BOWLES WT. The most common cause of hematuria (gross or microscopic) is idiopathic. This activity illustrates the evaluation, diagnosis, treatment, and management of hematuria and the importance of a team approach to its management. Diagnostic approach, differential diagnosis, and management of a small renal mass. Okay to delete this slide if the diagnosis was already given Differential diagnosis for painless hematuria. Recreational use of synthetic cannabinoids (SCs), also known as "K2" or "Spice," is becoming a major public-health concern due to their potential for abuse and harmful consequences. Hematuria can be gross or microscopic; gross hematuria is visible blood in urine whereas microscopic hematuria refers to the detection of blood on urinalysis or urine microscopy. Can turn toilet water colour pale pink or bright red. Microscopic hematuria is a result of there being an amount of blood in the urine that can only be seen through a microscope. Differential Diagnosis of Hematuria - Differential Diagnosis of Hematuria Anatomy- renal cyst, AVM, hydronephrosis Boulders- renal stone, hypercalciuria Cancer- Wilm s tumor , adenocarcinoma . Microscopic hematuria is present when microscopic inspection of at least 2 properly collected urine specimens show > 3 RBCs per high-powered field (hpf). Remove this presentation Flag as Inappropriate I Don't Like This I like this Remember as a Favorite. PMID 26063863. Classical red urine. Hematuria can derive from the kidneys, ureters, bladder, prostate (in men), or urethra.. Learning Point. Differential Diagnosis of Hemolysis . It is an alarming symptom and may be the first manifestation of ADPKD. Last updated: 28 Jan 2022 Summary Visible (gross) hematuria is urine that is visibly discolored by blood or blood clot. Common and important causes of painless hematuria for doctors and medical students This page is currently being written and will be available soon. To be updated when it is complete please like us on Facebook, follow us on Twitter or subscribe on YouTube using the 'follow us' buttons. •Incidence of hematuria with BPH reported to be as high as 12% •BPH causing gross hematuria requiring transfusions . JOCHIMS J. Kinderarztl Prax, 24(9):409-418, 01 Sep 1956 Cited by: 0 articles | PMID: 13377565. Differential Diagnosis . ↑ Nassar FA, Abu-Elamreen FH, Shubair ME, Sharif FA (2008). The differential diagnosis of hematuria can be remembered using the pneumonic SHIRT: S - Stones (Urolithiasis) H - Hematologic abnormalities. Hematuria is blood in the urine. Once the hepatology service identified portal hypertension, the patient was taken to the operating . Visible haematuria, even when transient or asymptomatic, may indicate a signif. When the urine is red or pink this could be linked to blood in the urine and is called "gross" or "visible" hematuria. Differential diagnosis for painless hematuria. Hematuria may be asymptomatic or symptomatic and may be associated with other urinary tract abnormalities. After completing this article, readers should be able to: An 8-year-old white girl is referred for evaluation of hematuria, proteinuria, and hypertension. Patients with microscopic hematuria (i.e., at least three red blood cells per high-power field in two of three specimens) should be evaluated to exclude renal and urinary tract disease. This. Glomerular hematuria 11. Serum creatinine level was 3.3mg/dL, from a baseline serum creatinine level of .8mg/dL 2 weeks earlier. We discuss the common causes of hematuria and how to evaluate it. Some authors recommend that 2 of 3 urinalyses show microhematuria before an evaluation is undertaken. •The timing of hematuria. The presence of small round blue cell tumors in urine has a broad differential diagnosis, including but not limited to small cell carcinoma, lymphoma, and high-grade urothelial carcinoma. View large Download PPT. Describe the differential diagnoses of hematuria Review the appropriate investigation and management of hematuria Determine when to refer a patient with hematuria to a urologist Macroscopic (gross) vs. microscopic . Pediatrics provides the authoritative, evidence-based research you need to stay current and to optimize pediatric care. In this brief review on hematuria, we practically addressed the etiology, types, common reasons, differential diagnosis, clinical presentation and practical diagnostic approach to this condition . Hematuria that is not explained by an obvious underlying condition (eg, cystitis, ureteral stone) is fairly common. Differentiation Diagnosis: -Leukemia, rhabdomyosarcoma, nasopharyngeal carcinoma, germ cell tumors, thymoma - Nonmalignant : EBV infection, branchial cleft& thyroglossal duct cysts, cat scratch disease, bacterial or viral lymphadenitis, mycobacteria, toxoplasmosis Generally, hematuria is defined as the presence of 5 or more red blood cells (RBCs) per high-power field in 3 of 3 consecutive centrifuged specimens obtained at least 1 week apart. HEMATURIA. Hematuria Paroxysmal nocturnal hemoglo-binuria, intravascular hemolysis Medications (Table 4) Drug-induced thrombotic microangiopathic anemia, 1. Hematuria that is not explained by an obvious underlying condition (eg, cystitis, ureteral stone) is fairly common. 97 Painful - infection Painless neoplastic, hyperplastic, vascular Gross urine appears RED ; lower tract prob. This is performed via computed tomography urography (CTU) (criterion standard) or noncontrast renal CT scanning, noncontrasted magnetic resonance imaging, or ultrasonography with retrograde pyelography. The workup of hematuria per American Urology Association guidelines includes imaging of the upper urinary tracts. The hematuria is usually asymptomatic but may be associated with left flank pain. Differential Diagnosis of Hematuria Microscopic Hematuria in 135 patients: Proteinuria <0.3 g/d Proteinuria up to 2.4 g/d Thin GBM 43% IgAN 46% IgAN 20% FSGS 13% Normal 37% Membranous, MPGN, AIN Acute prolif, Alport's Hall et al, Clin Nephrol, 2004 Natural History of Hematuria in 49 When blood is visible in the urine or when spots on the dipstick change color, indicating the presence of red blood cells, your child's doctor may make the diagnosis of hematuria. As little as 1 mL of blood can impart color to 1 liter of urine. Hematuria in the adult patient: Abdominal aortic aneurysm (AAA), urogenital tract cancer, renal emboli from endocarditis, urethritis, benign prostatic hypertrophy, prostatitis, epididymitis, endometriosis, papillary necrosis, anticoagulation. Recognize that hypercalciuria can be symptomatic even in the absence of a kidney stone. The . Hematuria occurs when blood enters the urinary collecting system and is excreted in the urine.There are many etiologies for hematuria, and they range from benign and transient to gravely concerning. Nevertheless, an orderly, comprehensive approach can greatly simplify the diagnosis.1 This paper briefly reviews the common causes of hematuria in adults, suggests an algo-rithmic approach to the workup (FIGURE 1), and Hematuria can be called either gross or microscopic. Other differentials for prostatomegaly include benign prostatic hyperplasia, prostatic cysts and prostatitis. Gross hematuria is common in autosomal dominant polycystic kidney disease (ADPKD). Vogt cautions that macroscopic hematuria has a broad differential. Microsoft PowerPoint - 2544_Hematuria_07.ppt Author: THE DIFFERENTIAL DIAGNOSIS OF HEMATURIA. A 75-year-old woman who received a deceased donor kidney transplant 3 months previously was admitted to the hospital for vomiting, diarrhea, and gross hematuria. The commonest etiology is. The first was at 3 years of age and was attributed to a urinary tract infection, but a urine culture was negative. About This Presentation. Nephritic syndrome is a broad category of glomerular diseases characterized by glomerular hematuria Hematuria Presence of blood in the urine. Hematuria is defined as the presence of blood in the urine. INTRODUCTION. Assessment of Patients with Hematuria Hematuria comes in two main varieties: gross and microscopic. It may present as urine that is red to brown, or as frank blood. Nephritic syndrome is characterized by glomerular capillary damage leading to hematuria, pyuria, water retention, and subsequent hypertension and edema.It can be caused by a variety of conditions including autoimmune, hereditary, and infectious diseases. Differential Diagnosis •UTI •Malignancy -Bladder cancer -Upper tract urothelial carcinoma . She was treated with 10 days of antibiotics, and the symptoms resolved. Read this chapter of The Patient History: An Evidence-Based Approach to Differential Diagnosis, 2e online now, exclusively on AccessMedicine. Differential. Many conditions can cause hematuria, but the differential diagnosis can be simplified with a systematic approach. "Detection of Chlamydia trachomatis and Mycoplasma hominis, genitalium and Ureaplasma urealyticum by polymerase chain reaction in patients with sterile pyuria". The differential diagnosis is now narrowed to focus on glomerular lesions that cause RPGN. Differential diagnosis The presence of mineralization within the prostate, along with the signalment (neutered, older male dog) makes prostatic neoplasia the most likely differential. Hematuria is rare in newborns. Visible hematuria, even when transient or asymptomatic, may indicate a significan. Differential Diagnosis of Hematuria - Differential Diagnosis of Hematuria Anatomy- renal cyst, AVM, hydronephrosis Boulders- renal stone, hypercalciuria Cancer- Wilm s tumor , adenocarcinoma . PowerPoint Presentation Author: The doctor may send your child's urine sample to a lab for further testing. The dearth of information on these newly added contents as they are introduced into the black market hinders risk assessments of these compounds. 4. She has had recurrent episodes of gross hematuria. 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