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Is there abdominal pain? The presence of abdominal pain with hematuria should first suggest renal calculus, but other causes, such as renal embolism, renal contusion, or laceration, must be considered.
Is there dysuria or frequency of ... DIAGNOSTIC WORKUP
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Are there significant RBCs in the urine? If so, one should consider glomerulonephritis, collagen disease, tuberculosis, neoplasm, trauma, renal calculus, and polycystic kidney disease. If not, the most likely etiology ... DIAGNOSTIC WORKUP
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... Red urine may be due to hematuria,
hemoglobinuria (hemolytic anemia), myoglobinuria (muscle trauma, myocardial infarction), and coproporphyria or uroporphyria (porphyria). Phenazopyridine hydrochloride (PyridiumŪ) also colors the urine red or orange. Ingestion of
... READ EXCERPTS »
...
Are there significant numbers of white blood cells (WBCs) in the urine? This would suggest a UTI. If there are white cell casts or clumps, the infection may be a pyelonephritis. A urine culture and colony count should be ordered. Sterile ... DIAGNOSTIC WORKUP
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Is the 24-hr urine volume increased? If the 24-hr urine volume is increased, then one has identified polyuria. The differential diagnosis of this condition is found on
page 372
.
Is there dysuria? If ... DIAGNOSTIC WORKUP
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Hematuria is the intermittent or persistent excretion of red or brown urine that can occur with a variety of clinical symptoms. The amount of blood can be grossly evident or microscopic. About 2.5% of the general population has asymptomatic hematuria. It is important to evaluate the... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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...
Hematuria is defined as >5 red blood cells per high-power field in a freshly voided, spun urine specimen. Macroscopic (gross) hematuria is less common, is more likely to be attributed to an identified cause, and is always “pathologic.” Cola-colored urine, hematuria... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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...
Pyuria is defined as the presence of white blood cells in the urine. This condition is commonly caused by urinary tract infection, asymptomatic bacteriuria, or vaginal contamination of the urine specimen.
Differential Diagnosis
... Workup and Diagnosis ... Treatment
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Proteinuria in children is defined as a quantitative 24-hour urine collection with >4 mg/m2/hour (>100 mg/m2/day) of protein. Semiquantitative definitions include urine dipstick ≥1+ (30 mg/dL) for specific gravity (SG) ≤1.015, or 2+... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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... Using the anatomic approach, the physician can arrive at most of the causes of hematuria ( Table 35 ). One need only visualize the urinary tract and proceed from the kidney on down to get a differential list. Let us apply the mnemonic VINDICATE to the kidney:
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... Pyuria is included here although it is not a symptom or a definitive finding on physical examination. Examination of the urine, however, is so frequently a part of every physical examination that the causes of pyuria should be available for immediate recall for
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... Apart from hematuria, red urine may signify hemoglobinuria or myoglobinuria, suggesting the various hemolytic anemias, the march hemoglobinuria, paroxysmal “cold” hemoglobinuria and nocturnal hemoglobinuria, and the Crush syndrome. Red urine is also found in
... READ EXCERPTS »
... There are many causes of proteinuria. The mnemonic VINDICATE is a helpful way of developing a list of possibilities.
PROTEINURIA
V—Vascular category should call to mind CHF
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... Frequency of urination may be due to polyuria (increased output of urine), obstruction to the output of urine (requiring frequent voiding to get the urine out) because the net capacity of the bladder is reduced, or irritative lesions in or near the urinary tract.
Polyuria.
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... A cardinal sign of renal and urinary tract disorders, hematuria is the abnormal presence of blood in urine Strictly defined, it means three or more red blood cells (RBCs) per high-power microscopic field in urine Microscopic hematuria is confirmed by an occult... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pictures
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... Cloudy, murky, or turbid urine reflects the presence of bacteria, mucus, leukocytes or erythrocytes, epithelial cells, fat, or phosphates (in alkaline urine). It’s characteristic of urinary tract infection (UTI) but can also result from prolonged storage of... History and physical examination ... Medical causes ... Special considerations ... Pediatric pointers
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... Pseudohematuria (Dyes and Pigments)
Beets
Food dyes
Phenytoin
Rifampin
Pyridium
Urates
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... Benign/Physiologic
Fever
Exercise
Orthostatic
Contrast dye
Usually Nonnephritic
Chronic pyelonephritis
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... A cardinal sign of renal and urinary tract disorders, hematuria is the abnormal presence of blood in the urine. Strictly defined, it means three or more red blood cells (RBCs) per high-power microscopic field in the urine. Microscopic hematuria is confirmed by an occult blood... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
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... Cloudy, murky, or turbid urine reflects the presence of bacteria, mucus, leukocytes or erythrocytes, epithelial cells, fat, or phosphates (in alkaline urine). It’s characteristic of urinary tract infection (UTI), but it can also result from prolonged... History and physical examination ... Medical causes ... Special considerations ... Pediatric pointers
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... Siegfried Schmidt and Ku-Lang Chang
Hematuria, defined as “blood in the urine,” is encountered frequently in family practice. It can occur as gross (macroscopic) hematuria with obvious reddish discoloration... Approach ... History ... Physical examination ... Testing ... Diagnostic assessment
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... Irene M. Hamrick
The prevalence of proteinuria in the general population is 3%, and 5% in healthy adolescents (1). Heavy and persistent proteinuria is associated with the development of end-stage renal disease in patients with glomerular
... READ EXCERPTS »
... Differential Overview
❑ Urinary tract infection
❑ Nephrolithiasis
❑ Anticoagulation
❑ Long distance running
❑... Diagnostic Approach ... Clinical Findings
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... Differential Overview
❑ Diabetes
❑ Drugs/toxins
❑ Acute tubular necrosis
❑ Glomerulonephritis
... Diagnostic Approach ... Clinical Findings
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... A cardinal sign of renal and urinary tract disorders, hematuria is the abnormal presence of blood in the urine. Microscopic hematuria is confirmed by an occult blood test, whereas macroscopic hematuria is immediately visible. However,... History ... Physical assessment ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
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... Hematuria—presenceof blood in urine—can be microscopic (urine is not discolored) orgross (urine has red or brown discoloration). >5 red cells per high-powerfield in centrifuged urinary sediment is considered abnormal. Hematuria can... Principal Causes of Hematuria ... Clinical Features and Diagnosis ... Diagnostic Approach ... References
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... Proteinuriais a common finding in childhood and adolescence. Usual pathogenesis involves increasein permeability of glomerular basement membrane. Less common isdecreased absorption or increased secretion of protein by renaltubules, which may occur with... Principal Causes of Proteinuria ... Clinical Features and Diagnosis ... Diagnostic Approach ... References
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... A cardinal sign of renal and urinary tract disorders, hematuria is the abnormal presence of blood in urine. Strictly defined, it means three or more red blood cells (RBCs) per high-power microscopic field in urine. Microscopic hematuria is confirmed by an... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
... READ EXCERPTS »
... Cloudy, murky, or turbid urine reflects the presence of bacteria, mucus, leukocytes or erythrocytes, epithelial cells, fat, or phosphates (in alkaline urine). It's characteristic of urinary tract infection (UTI) but can also result from prolonged storage of... History and physical examination ... Medical causes ... Nursing considerations ... Patient teaching
... READ EXCERPTS »
...
Using the anatomic approach, the physician can arrive at most of
the causes of hematuria (Table 35). One need only visualize the
urinary tract and proceed from the kidney on down to get a differential
list. Let us apply the mnemonic ... Pictures
... READ EXCERPTS »
...
Pyuria is included here although it is not a symptom or a definitive
finding on physical examination. Examination of the urine, however, is so
frequently a part of every physical examination that the causes of pyuria ... Pictures
... READ EXCERPTS »
...
Apart from hematuria, red urine may signify hemoglobinuria or
myoglobinuria, suggesting the various hemolytic anemias, the march
hemoglobinuria, paroxysmal “cold” hemoglobinuria and nocturnal
hemoglobinuria, and... Pictures
... READ EXCERPTS »
...
Frequency of urination may be due to polyuria (increased output of
urine), obstruction to the output of urine (requiring frequent voiding to
get the urine out) because the net capacity of the bladder is reduced, or
irritative lesions in or... Pictures
... READ EXCERPTS »
...
There are many causes of proteinuria. The mnemonic VINDICATE is a
helpful way of developing a list of possibilities.
V—Vascular category should call to mind CHF, hypertension, and
renal vein thrombosis.
I—Inflammation.... Pictures
... READ EXCERPTS »
... Andres J. Greco, MD Proteinuria - BASICS Proteinuria - description Protein may be found in the urine of healthy children. The term proteinuria is used to indicate urinary protein excretion beyond the upper limit ... Proteinuria - DIAGNOSIS ... Proteinuria - bibliography ... Proteinuria - CODES ... Proteinuria - FAQ
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