Bleeding

Renal & Urinary System


{"ops":[{"insert":"Evaluation of hematuria"},{"insert":"\n","attributes":{"header":1}},{"insert":"Gross hematuria is always significant, and may be a sign of serious urological illness.\r\n \r\nAfter ruling out urinary tract infections and other common causes (trauma, vigorous exercise, or myoglobinuria), assessment should include a careful examination and some labwork, including:\r\n\r\n- Urea and electrolytes with urine analysis to exclude renal parenchymal disease\r\n- A full blood count to exclude post-haemorrhage anemia or thrombocytopenia\r\n- Liver and coagulation profiles to exclude coagulation disorders\r\n- Urine cytology and cultures to exclude infections, and to screen for malignancy\n"},{"insert":"Urine cytology in the evaluation of hematuria"},{"insert":"\n","attributes":{"header":1}},{"insert":"The American Urological Association (AUA) makes no recommendations regarding urine cytology in the primary assessment of hematuria.\r\n \r\nHowever, recent European Association of Urology (EAU), National Comprehensive Cancer Network (NCCN), and Canadian Urological Association (CUA) guidelines all recommend performing urine cytology when evaluating gross hematuria in patients \u003E40 years of age.\r\n \r\nUrine cytology has good specificity and sensitivity for the detection of high-grade tumors, but not for low grade lesions. It should be performed on fresh, mid-stream urine, and the urethra should be cleaned before the sample is taken. \r\n\r\nPositive urine cytology warrants further investigation to confirm malignancy. However, a negative result does not "}]}

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