Term
| what is the most common cause of hematuria? |
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Definition
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Term
| what is the most common symptom of urothelial CA? |
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Definition
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Term
| what constitutes hematuria? |
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Definition
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Term
| what % of pts w/asymptomatic hematuria have major pathology? |
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Definition
| 20% - 2/3 of whom have GU CA |
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Term
| what should f/u a positive urine dipstick for blood? |
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Definition
| a microscopic evaluation of the urine sediment, urine cytology (for CA), and thorough physical exam |
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Term
| what are questions to ask about hematuria? |
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Definition
| *is it initial, total or terminal? (initial: bleeding distal to external urinary sphincter, total: bladder/kidney, terminal: bleeding proximal to external urinary sphincter). *color? *clots? (blobs=from bladder, long+stringy=from ureter). discomfort? (dysuria=infection). do you smoke? (most common cause of bladder/kidney CA). contact w/environmental carginogens? (petroleum, hair dye). associated w/dysuria, urgency, increased frequency? (commonly: infection) |
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Term
| what are the most common causes of hematuria in neonates? |
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Definition
| bleeding tendencies, UPJ (ureteropelvic junction) obstruction, renal vein thrombosis, etc |
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Term
| what are the most common causes of hematuria in children? |
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Definition
| UTI, glomerulonephritis, coagulapathy |
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Term
| what are the most common causes of hematuria in adults <40? |
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Definition
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Term
| what are the most common causes of hematuria in adults >40? |
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Definition
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Term
| what are the most common causes of hematuria in men >60? |
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Definition
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Term
| what are the most common causes of hematuria in women >60? |
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Definition
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Term
| what are common causes of painless gross and microscopic hematuria? |
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Definition
| renal neoplasm (kidney, renal pelvis), ureteral neoplasm, bladder neoplasm, nonobstructing calculus (kidney or bladder), chronic obstruction (UPJ, etc), nephropathy/nephritides, anticoagulant therapy (coumadin/warfarin), sickle cell disease/trait, idiopathic (follow these pts, concerned about small neoplasms) |
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Term
| what are common causes of painful gross and microscopic hematuria? |
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Definition
| UTI (upper: flank/abdomen pain, fever, n/v, lower: suprapubic burning bladder pain), calculus (obstructing or passing: renal or ureteric), trauma, and neoplasm (obstructing type) |
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Term
| what are diagnostic studies performed for hematuria? |
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Definition
| urinalysis, urine cytology (do if hematuria continues after infection is cleared), spiral CT/urogram (contrast shows tumors better and w/o contrast you can see stones better), IVP (rare), ultrasound (not good initial study, good for general scan of hydronephrosis, tumors, & stones), cystourethroscopy (catches small tumors CT may miss), retrograde pyelography (r/o urothelium CA), ureterorenoscopy/bx, renal scanning, and renal bx (90% solid tumors from kidney=malignant) |
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Term
| what is are possible causes of hematuria in the kidney? |
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Definition
| CA (urothelial/parenchymal), infection, calculus, trauma, obstruction, cystic disease (very common, can be benign/malignant), sickle cell, vascular malformations, renal vein thrombosis, and TB |
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Term
| what is are possible causes of hematuria in the ureter? |
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Definition
| calculus, CA, infection, inflammation, stricture, TB, trauma, and obstruction |
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Term
| what is are possible causes of hematuria in the bladder? |
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Definition
| CA, infection, inflammation, neurogenic dysfunction, calculus, bladder outlet obstruction, trauma, parasitic disease, and TB |
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Term
| what is are possible causes of hematuria in the prostate gland? |
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Definition
| BPH (as it enlarges=more vascular), CA (if this is causing hematuria=very advanced), infection, inflammation, prostatic calculi (common, rarely symptomatic), infarction (asymptomatic) |
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Term
| what is are possible causes of hematuria in the urethra? |
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Definition
| infection, inflammation, stricture, trauma, foreign body, calculus, CA |
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Term
| what % of pts w/asymptomaticpts w/hematuria will require tx? |
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Definition
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Term
| why is it better to follow an initial CT scan w/an ultrasound? |
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Definition
| less radiation=better, cheaper |
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Term
| what is the good thing about most bladder CA? |
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Definition
| 80% are superficial and well differentiated - easier to remove, don't usually have to remove entire bladder |
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