1. Haematuria

2. History The passage of clots in urine is indicative of Glomerular origin? Extraglomerular origin? A history of haematuria, enuresis, dysuria, abdominal pain & fever is indicative of UTI

3. A patient with Crohn’s disease says his urine has become dark coloured and wonders if he should be concerned. What might be happening? IgA nephropathy

4. History Several 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?

5. A patient says he is now producing only small amounts of dark urine. What other examinations would you perform: Vitals, especially BP Detailed skin inspection (why?) Abdominal examination to look for palpable kidneys (Wilm’s tumour, hydronephrosis, cystic kidney diseases, carcinoma) DRE (BPH, prostate CA) Urine dipstick test

6. A 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 Henoch–Schönlein purpura

7. 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 syndrome

8. A 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 syndrome Rapidly progressive (crescentic) glomerulonephritis Type I anti-GBM antibodies

9. 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 intake Trauma (including masturbation), strenuous exercise, foreign body (kids & weirdos), UTI, sickle cell disease, tumours, drugs

10. Foods: beets, blackberries, rhubarb Drugs: senna, antipsychotics, rifampicin Illness: Porphyria, hepatitis

11. ASO – antistreptolysin O (post strep glomerulonephritis), MPGN: membranoproliferative glomerulonephritis

12. VCUG: voiding cystourethrogram UPJ: Uretopelvic junction PUV: posterior urethral valves MCKD: medullary cystic kidney disease VUR: vesicoureteral reflux