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Haematuria

HistoryThe passage of clots in urine is indicative ofGlomerular origin?Extraglomerular origin?

A history of haematuria, enuresis, dysuria, abdominal pain & fever is indicative of UTIA patient with Crohns disease says his urine has become dark coloured and wonders if he should be concerned. What might be happening?IgA nephropathy

HistorySeveral weeks after you treated this child with cephalexin, his mother complains that his urine has become dark. She is angry and thinks the antibiotic has caused him harm. What do you say?

A patient says he is now producing only small amounts of dark urine. What other examinations would you perform:Vitals, especially BPDetailed skin inspection (why?)Abdominal examination to look for palpable kidneys (Wilms tumour, hydronephrosis, cystic kidney diseases, carcinoma)DRE (BPH, prostate CA)Urine dipstick testA child with this rash is brought in complaining of colicky abdo pain, nausea, vomiting with mucus and some blood in the stools. The mother complains that the urine has become a little darker and infrequent but puts this down to dehydration. What may be happening here?IgA nephropathy with HenochSchnlein purpura

A teenager says he is having problems understanding conversations, especially when other noises are around. He thinks loud music is the cause.Of course you first thought of performing a DRE but instead went for the second best option of taking a urine sample. The dipstick indicates haematuria. What might be happening?Alport syndromeA patient has been admitted to the ICU with respiratory failure. His pockets are full of bloody tissues. Following catheterisation a small amount of dark urine is produced. Describe this condition:Goodpasture syndromeRapidly progressive (crescentic) glomerulonephritisType I anti-GBM antibodies

You come home from uni and your vegan hippy housemate, who takes calcium and vitamin C & D supplements, is doubled up lying on the bathroom floor in agony. It just started after he passed bloody urine. What might be happening? What are other causes of non-glomerular haematuria?Urolithiasis most likely from excessive calcium intakeTrauma (including masturbation), strenuous exercise, foreign body (kids & weirdos), UTI, sickle cell disease, tumours, drugs

Foods: beets, blackberries, rhubarbDrugs: senna, antipsychotics, rifampicinIllness: Porphyria, hepatitis

ASO antistreptolysin O (post strep glomerulonephritis), MPGN: membranoproliferative glomerulonephritisASO antistreptolysin O (post strep glomerulonephritis), MPGN: membranoproliferative glomerulonephritis11

VCUG: voiding cystourethrogramUPJ: Uretopelvic junctionPUV: posterior urethral valvesMCKD: medullary cystic kidney diseaseVUR: vesicoureteral refluxVCUG: voiding cystourethrogramUPJ: Uretopelvic junction, PUV: posterior urethral valves, MCKD: medullary cystic kidney disease, VUR: vesicoureteral reflux12