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Hematuria

  • Common ddx

    • kidney stone, cystitis, glomerulonephritis, IgA nephropathy, poststrep glomerulonephritis, UTI, coagulopathy, sickle cell disease
  • Serious ddx

    • bladder cancer, rhabdomyolysis, pyelonephritis, RCC, urethral trauma
  • Labs

    • UA with sediment
    • coags
    • complement
    • cystoscopy if suspect bladder cancer
    • retrograde urethrogram if blood in meatus
  • Kidney ddx

    • kidney stone, pyelonephritis, RCC, renal contusion, laceration, PCKD, Runner's hematuria, necrosis/ischemia, Wilms tumor
  • Vasculitis ddx

    • Wegener, CSS
  • Glomerulonephritis ddx

    • Goodpasture
    • HSP
    • IgA nephropathy (recent URTI)
    • lupus
    • cryoglobulinemia
    • MPGN (low C3, nl C4)
    • poststrep glomerulonephritis
    • Alport syndrome (hearing loss)
  • Ureter ddx

    • ureteral stone, ureteral tumor
  • Bladder ddx

    • cystitis, bladder cancer, bladder stone, schistosoma
  • Urethra ddx

    • urethritis, trauma (blood in meatus)
  • Infection ddx

    • UTI, pyelonephritis, cystitis, urethritis, prostatitis, TB
  • Hemonc ddx

    • thrombocytopenia, warfarin, coagulopathy, sickle cell disease/trait, leukemia
  • Other ddx

    • rhabdomyolysis, myoglobinuria, ruptured AAA, fistula (surg hx)
  • HPI

    • onset
    • triggering event
    • alleviates, aggravates
    • quality: frank blood vs coke color
    • quantity, frequency
    • associated pains
  • ROS

    • fever, nightsweats, wt loss
    • ENT: nasal ulcers
    • cardio: chest pain
    • pulm: cough, hemoptysis
    • GI: nausea, vomiting, diarrhea, abdominal pain
    • GU: flank pain, dysuria, discharge
    • MSK: myalgia, arthralgia
    • trauma
  • PMH

    • HTN
    • sickle cell
    • coagulopathy
    • STDs
  • FH

  • SH

    • smoking hx
    • hx of strenuous exercise
    • foreign travel
  • Meds

    • warfarin, anticoagulation
  • Allergies

  • Px

    • vitals
    • gen impression
    • skin: rash, purpura
    • ENT: nasal, oral ulcers
    • cardio
    • pulm
    • abdominal: mass, tenderness
    • renal: flank mass, CVA tenderness
    • ext: arthritis
    • genital: blood in meatus

  • Print | Citations

    Disclaimer: MDHero Workups is for educational use only, and is not meant to replace the clinical judgement of a professional. We do not guarantee the accuracy of any information on this website.