Medial notes (surgery)

Pic - http://www.drugs.com/health-guide/hematuria.html

Hematuria

Hematuria is defined as blood in urine.

The blood can be microscopic and macroscopic.

It can also be early (at the start of urination)(urethra),  terminal (at the end) (bladder neck, prostrate), diffuse (throughout) (kidney, upper UTI).
Pseudo hematuria is pigmentation of urine by food.

Causes
Infection -
1.acute glomurulonephritis
2. TB
Infarction
1.Emboli in sub acute endocarditis to renal infact
2.Mismatched Blood transfusion
Injury
1.Stab or burn
Tumors
1.Wilms' tumor
2.Transitional cell carcinoma
Stones
Polycyclic kidney
Bleeding disorders- stickle cell.
BPH

Most common problems

Stone (ureter, urethra,  bladder)
Tumor (carcinoma bladder, prostrate)

Investigation
History
Age, Occupation

Color of urine (bright red, altered), Amount (small.rcc, profuse.papilloma)

Painless or painful

Early, terminal or diffuse

General exam- pallor, BP
Abdominal exam- kidneys palpable, bladder,

Rectal exam- prostrate.
Plain X- ray KUB
Urine exam- microscopy, culture, biochemistry (albumin, creatinine, urea)
Ultrasounds
IVP, IVUgraphy
CT
Urethroscope, cystoscope

Management- treat anemia, maintain blood volume and electrolytes, antibiotics, treat the cause.