Presentation on theme: "Hematuria Wanda C. Hancock, MHSA, PA-C. Objectives Discover the presenting symptoms for hematuria and the anticipated decision path for its etiology Develop."— Presentation transcript:
Objectives Discover the presenting symptoms for hematuria and the anticipated decision path for its etiology Develop an initial differential diagnosis for hematuria Consider the diagnostic orders for developing the diagnosis Determine the likely follow up testing.
Hematuria is a sign of malignancy until proven otherwise
Incidence 43% of microscopic hematuria has no etiology 5% of microscopic hematuria is cancer 23% of gross has cancer as an initial finding 8% has no etiology initially but 18% findings later
Causes Cancer BPH Trauma Surgery/instrumentation Medications Renal Disease Exercise Stones Radiation Chemotherapy Fever Benzenes UTI Recent URTI
Risk Factors Age Smoking Trauma Previous exposure to chemicals
How to Shine…. Gross or microscopic? Timing? Pain? Clots?
Gross VS Micro Gross hematuria Always needs evaluation Sources Microscopic Dip stick has 90% sensitivity 3-5 RBC HPF 2 of 3 tests positive
Timing …. Initiation of the stream Terminal hematuria Throughout the micturation
Painful versus painless Painful Cystitis Stones Painless Neoplasm