Hematuria, or blood in the urine, can be caused by diseases of the urinary system or other systemic disorders. It is classified as microscopic or gross based on visibility, and as early, terminal, or diffuse based on timing during urination. Common causes include glomerular diseases, infections, cancers, trauma, and stones. Diagnosis involves urinalysis, microscopy, imaging, and sometimes kidney biopsy. Treatment focuses on the underlying condition causing the hematuria. Prognosis depends on associated clinical or laboratory abnormalities, with isolated microscopic hematuria generally having a good prognosis.
Hematuria for undergraduates
this is a presentation i prepared for medical students about hematuria, hope u like it
for more urology resources visit:
www.uronotes2012.blogspot.com
Urolithiasis is a common disease that is estimated to
produce medical costs of $2.1 billion per year in the United States alone.
Renal colic affects approximately 1.2 million people
each year in USA and accounts for approximately 1% of
all hospital admissions.
Most active emergency departments (EDs) manage
patients with acute renal colic every day.
Hematuria for undergraduates
this is a presentation i prepared for medical students about hematuria, hope u like it
for more urology resources visit:
www.uronotes2012.blogspot.com
Urolithiasis is a common disease that is estimated to
produce medical costs of $2.1 billion per year in the United States alone.
Renal colic affects approximately 1.2 million people
each year in USA and accounts for approximately 1% of
all hospital admissions.
Most active emergency departments (EDs) manage
patients with acute renal colic every day.
Pyelonephritis
It is the inflammation of the kidney & upper urinary tract that usually results from the bacterial infection of the bladder.
Pyelonephritis can be classified in several different catagories:
-acute pyelonephritis
-chronic pyelonephritis
-xanthogranulomatous pyelonephritis
Explanation of what splenomegaly is in relation to its dimension deviation from normal spleen.Classification of splenomegaly according to it's size in adult and pediatric. The causes of splenomegaly along with the symptom that would manifest as a result of this anomaly. Lastly, diagnosis of splenomegaly
Pyelonephritis
It is the inflammation of the kidney & upper urinary tract that usually results from the bacterial infection of the bladder.
Pyelonephritis can be classified in several different catagories:
-acute pyelonephritis
-chronic pyelonephritis
-xanthogranulomatous pyelonephritis
Explanation of what splenomegaly is in relation to its dimension deviation from normal spleen.Classification of splenomegaly according to it's size in adult and pediatric. The causes of splenomegaly along with the symptom that would manifest as a result of this anomaly. Lastly, diagnosis of splenomegaly
Evaluation of the patient with hematuria , with recent update in Diagnosis, Evaluation, and Follow-up of asymptomatic microscopic hematuria (AMH) in Adult | american association of urology AUA guideline
Approach to Hematuria including:
Definition of Hematuria.
Pathophysiology of Hematuria.
Differential Diagnosis of Red Urine.
Causes of Hematuria.
Approach to a patient with Hematuria.
Diagnostic Algorithms.
Management and Disposition.
The French Revolution, which began in 1789, was a period of radical social and political upheaval in France. It marked the decline of absolute monarchies, the rise of secular and democratic republics, and the eventual rise of Napoleon Bonaparte. This revolutionary period is crucial in understanding the transition from feudalism to modernity in Europe.
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Acetabularia Information For Class 9 .docxvaibhavrinwa19
Acetabularia acetabulum is a single-celled green alga that in its vegetative state is morphologically differentiated into a basal rhizoid and an axially elongated stalk, which bears whorls of branching hairs. The single diploid nucleus resides in the rhizoid.
June 3, 2024 Anti-Semitism Letter Sent to MIT President Kornbluth and MIT Cor...Levi Shapiro
Letter from the Congress of the United States regarding Anti-Semitism sent June 3rd to MIT President Sally Kornbluth, MIT Corp Chair, Mark Gorenberg
Dear Dr. Kornbluth and Mr. Gorenberg,
The US House of Representatives is deeply concerned by ongoing and pervasive acts of antisemitic
harassment and intimidation at the Massachusetts Institute of Technology (MIT). Failing to act decisively to ensure a safe learning environment for all students would be a grave dereliction of your responsibilities as President of MIT and Chair of the MIT Corporation.
This Congress will not stand idly by and allow an environment hostile to Jewish students to persist. The House believes that your institution is in violation of Title VI of the Civil Rights Act, and the inability or
unwillingness to rectify this violation through action requires accountability.
Postsecondary education is a unique opportunity for students to learn and have their ideas and beliefs challenged. However, universities receiving hundreds of millions of federal funds annually have denied
students that opportunity and have been hijacked to become venues for the promotion of terrorism, antisemitic harassment and intimidation, unlawful encampments, and in some cases, assaults and riots.
The House of Representatives will not countenance the use of federal funds to indoctrinate students into hateful, antisemitic, anti-American supporters of terrorism. Investigations into campus antisemitism by the Committee on Education and the Workforce and the Committee on Ways and Means have been expanded into a Congress-wide probe across all relevant jurisdictions to address this national crisis. The undersigned Committees will conduct oversight into the use of federal funds at MIT and its learning environment under authorities granted to each Committee.
• The Committee on Education and the Workforce has been investigating your institution since December 7, 2023. The Committee has broad jurisdiction over postsecondary education, including its compliance with Title VI of the Civil Rights Act, campus safety concerns over disruptions to the learning environment, and the awarding of federal student aid under the Higher Education Act.
• The Committee on Oversight and Accountability is investigating the sources of funding and other support flowing to groups espousing pro-Hamas propaganda and engaged in antisemitic harassment and intimidation of students. The Committee on Oversight and Accountability is the principal oversight committee of the US House of Representatives and has broad authority to investigate “any matter” at “any time” under House Rule X.
• The Committee on Ways and Means has been investigating several universities since November 15, 2023, when the Committee held a hearing entitled From Ivory Towers to Dark Corners: Investigating the Nexus Between Antisemitism, Tax-Exempt Universities, and Terror Financing. The Committee followed the hearing with letters to those institutions on January 10, 202
A Strategic Approach: GenAI in EducationPeter Windle
Artificial Intelligence (AI) technologies such as Generative AI, Image Generators and Large Language Models have had a dramatic impact on teaching, learning and assessment over the past 18 months. The most immediate threat AI posed was to Academic Integrity with Higher Education Institutes (HEIs) focusing their efforts on combating the use of GenAI in assessment. Guidelines were developed for staff and students, policies put in place too. Innovative educators have forged paths in the use of Generative AI for teaching, learning and assessments leading to pockets of transformation springing up across HEIs, often with little or no top-down guidance, support or direction.
This Gasta posits a strategic approach to integrating AI into HEIs to prepare staff, students and the curriculum for an evolving world and workplace. We will highlight the advantages of working with these technologies beyond the realm of teaching, learning and assessment by considering prompt engineering skills, industry impact, curriculum changes, and the need for staff upskilling. In contrast, not engaging strategically with Generative AI poses risks, including falling behind peers, missed opportunities and failing to ensure our graduates remain employable. The rapid evolution of AI technologies necessitates a proactive and strategic approach if we are to remain relevant.
Palestine last event orientationfvgnh .pptxRaedMohamed3
An EFL lesson about the current events in Palestine. It is intended to be for intermediate students who wish to increase their listening skills through a short lesson in power point.
Embracing GenAI - A Strategic ImperativePeter Windle
Artificial Intelligence (AI) technologies such as Generative AI, Image Generators and Large Language Models have had a dramatic impact on teaching, learning and assessment over the past 18 months. The most immediate threat AI posed was to Academic Integrity with Higher Education Institutes (HEIs) focusing their efforts on combating the use of GenAI in assessment. Guidelines were developed for staff and students, policies put in place too. Innovative educators have forged paths in the use of Generative AI for teaching, learning and assessments leading to pockets of transformation springing up across HEIs, often with little or no top-down guidance, support or direction.
This Gasta posits a strategic approach to integrating AI into HEIs to prepare staff, students and the curriculum for an evolving world and workplace. We will highlight the advantages of working with these technologies beyond the realm of teaching, learning and assessment by considering prompt engineering skills, industry impact, curriculum changes, and the need for staff upskilling. In contrast, not engaging strategically with Generative AI poses risks, including falling behind peers, missed opportunities and failing to ensure our graduates remain employable. The rapid evolution of AI technologies necessitates a proactive and strategic approach if we are to remain relevant.
2. Definition:
Hematuria is defined as the presence of 5 or more
red blood cells (RBCs) per high-power field in 3 of
3 consecutive centrifuged specimens obtained at
least 1 week apart.
3. Types:
According to the amount of RBC in the urine, hematuria can be
classified as:
Gross (ie,overtly bloody, smoky, or tea-colored urine)
Microscopic > 5 RBC”s /HPF
According to Timing (when it occurs during urination):
Early (initial) haematuria: Urethral origin, distal to external
Sphincter
Terminal haematuria: Bladder neck or prostate origin
Diffuse (total) haematuria: Source is in the bladder or upper
urinary tract
4. PATHOPHYSIO:
• Glomerular
• Non glomerular
False hematuria: Discolouration of urine from pigments such as food
colouring and myoglobin.
Silent hematuria is due to tumours of kidney or bladder unless proved
otherwise.
5. ETIOLOGY
Diseases of the urinary system – the
most common cause
Glomerular
Interstitial
Uroepithelium
Vascular
9. Diseases of adjacent organs
to urinary tract
Appendicitis
carcinoma of the rectum
carcinoma of the colon
uterocervical cancer
Drug and chemical agents anticoagulation
Cyclophosphamide, rifampin, sulfonamide, phenytoin,
Miscellaneous
exercise induced hematuria
11. DIFFERENTIAL DIAGNOSIS
• Polluted urine: menstruation
• Drug and food: Rifampicin, Nitrofurantoin, sulfonamides, adriamycin.
• Porphyria: porphyrin in urine (+)
• Hemoglobinuria (hemolysis)
• Myoglobinuria
12. Signs and symptoms
The first step in the evaluation of hematuria consists of a detailed and a
thorough physical examination.
Efforts should be made to distinguish glomerular causes from
extraglomerular one:
Passage of clots in urine suggests an extraglomerular cause
Fever, abdominal pain, dysuria, frequency, and recent enuresis in older
children may point to a urinary tract infection as the cause
Recent trauma to the abdomen may be indicative of hydronephrosis
Early-morning periorbital puffiness, weight gain, oliguria, dark-colored
urine, and edema or hypertension suggest a glomerular cause,
Hematuria due to glomerular causes is painless
Recent throat or skin infection may suggest postinfectious
glomerulonephritis
13. Joint pains, skin rashes, and prolonged fever in adolescents suggest
a collagen vascular disorder(Rheumatoid arthritis, Systemic lupus
erythematosus)
Skin rashes and arthritis can occur in Henoch-Schönlein
purpura and systemic lupus erythematosus
Information regarding exercise, menstruation, recent bladder
catheterization, intake of certain drugs or toxic substances, or
passage of a calculus may also assist in the differential diagnosis.
A family history that is suggestive of Alport syndrome, collagen
vascular diseases, urolithiasis, or polycystic kidney disease is
important
14. Physical examination
Measurement of the blood pressure and volume
status is especially important when glomerulonephritis is a
consideration.
Evaluation for the presence of periorbital puffiness or peripheral
edema
Detailed skin examination to look for purpura.
Abdominal examination to look for palpable mass reveals a
renal tumor or hydronephrosis may exist,
A palpable bladder after voiding indicates obstruction or
retention
15. A bruit over the kidney suggests a vascular cause.
Always check for extrarenal manifestations and co morbid
conditions.
Check for other sites of bleeding. PR examination should not be
missed. to diagnose prostatitis, prostate cancer, epididymitis,
meatal stenosis, and other structural causes of hematuria .
Inspect external genitalia in male for trauma.
Atrial fibrillation raises the possibility of renal embolic infarction,
especially if the patient has flank pain
Costovertebral angle tenderness is also suggestive of
pyelonephritis, nephrolithiasis, or ureteropelvic junction obstruction.
Detailed ophthalmologic evaluation (in familial hematuria)
16. Diagnosis
The laboratory tests ordered for the evaluation of hematuria must be
based on the clinical history and the physical examination. Tests that
may be helpful include the following:
Urinalysis with careful microscopic review of the urine sample
Urine dip strip analysis it is the most commonly used method of testing
the urine for blood is the urine test strip or dipstick, which utilizes the
peroxidase-like activity of hemoglobin to generate a color change.
False-positive tests may occur in the setting of myoglobinuria or
hemoglobinuria, confirmed by the absence of RBCs on microscopic
examination.
17. Phase-contrast microscopy to help determine the source of the
bleeding
Hematologic and coagulation studies (eg, complete blood count
[CBC] and, sometimes, platelet counts)
Blood urea nitrogen (BUN) for paraneoplastic syndrome and serum
creatinine levels for kidney failure.
Serologic testing (eg, complement, antistreptolysin [ASO], anti-
DNase B, antinuclear antibody [ANA], and double-stranded DNA
[dsDNA])
Urine culture for suspected
urinary tract infection (UTI)
18. Imaging studies
The following may be helpful:
Renal and bladder ultrasonography
Voiding cystourethrography
CT urography: now replaces IVU.
MRI.
Retrograde pyelography.
Renal biopsy: in nephrological cases
Cystoscopy
19. Kidney biopsy is rarely indicated:
Significant proteinuria
Abnormal renal function
Recurrent persistent hematuria
Serologic abnormalities (abnormal complement, ANA, or dsDNA
levels)
Recurrent gross hematuria
A family history of end-stage renal disease
20. Glomerular hematuria:
Brown-colored urine, RBC casts, and
dysmorphic (small, deformed, misshapen,
sometimes fragmented) RBCs and proteinuria
Nonglomerular hematuria:
Reddish or pink urine, passage of blood clots, and
eumorphic (normal-sized, biconcavely shaped)
Erythrocytes.
21. Management:
Hematuria is a sign and not itself a disease; thus,
therapy should be directed at the process causing it
Asymptomatic (isolated) hematuria generally does not
require treatment.
In conditions associated with abnormal clinical,
laboratory, or imaging studies, treatment may be
necessary, as appropriate, with the primary diagnosis
22. Surgical intervention may be necessary with certain anatomic
abnormalities (eg, ureteropelvic junction obstruction, tumor, or
significant urolithiasis)
Dietary modification is usually not indicated, except for children who
may tend to develop hypertension or edema as a result of the
primary disease process (eg, nephritis)
Patients with persistent microscopic hematuria should be monitored
every 6-12 months for the appearance of signs or symptoms
indicative of progressive renal disease
23. MORTALITY/MORBIDITY
• IN GENERAL, CHILDREN WITH ISOLATED ASYMPTOMATIC
MICROSCOPIC HEMATURIA TEND TO DO WELL,
• WHEREAS THOSE WITH ASSOCIATED FINDINGS
(EG, HYPERTENSION, PROTEINURIA, ABNORMAL SERUM
CREATININE LEVELS) ARE MORE LIKELY TO HAVE SERIOUS
PROBLEMS.
• BECAUSE HEMATURIA IS THE END RESULT OF VARIOUS
PROCESSES, THE MORBIDITY AND MORTALITY RATES OF
THE CONDITION DEPEND ON THE PRIMARY PROCESS THAT
INITIATED IT.
24. RACE:
• THE INCIDENCE OF HEMATURIA IN SPECIFIC
RACIAL GROUPS IS DETERMINED BY THE
PRIMARY CAUSE.
• FOR EXAMPLE, IDIOPATHIC HYPERCALCIURIA
IS INFREQUENT IN BLACK AND ASIAN
CHILDREN,
• BUT RELATIVELY COMMON IN WHITES.
CONVERSELY, HEMATURIA CAUSED BY SICKLE
CELL DISEASE IS MORE COMMON IN BLACKS
THAN IN WHITES.
25. SEX:
• SEX MAY PREDISPOSE A CHILD TO SPECIFIC
DISEASES THAT MANIFEST AS HEMATURIA.
• FOR EXAMPLE, THE SEX-LINKED FORM
OF ALPORT SYNDROME HAS A MALE
PREPONDERANCE,
• WHEREAS LUPUS NEPHRITIS IS MORE
COMMON IN ADOLESCENT GIRLS
26. AGE:
• PREVALENCE OF CERTAIN CONDITIONS VARIES WITH AGE.
•
FOR INSTANCE, WILMS TUMORS ARE MORE FREQUENT IN
CHILDREN OF PRESCHOOL AGE,
• WHEREAS ACUTE POSTINFECTIOUS GLOMERULONEPHRITIS
IS MORE FREQUENT IN THE SCHOOL-AGED POPULATION.
• IN ADULTS, HEMATURIA IS OFTEN A SIGN OF MALIGNANCY OF
THE GENITOURINARY TRACT (EG, RENAL CELL CARCINOMA,
BLADDER TUMORS, PROSTATIC TUMORS). THESE CONDITIONS
ARE RARE IN CHILDREN.