UROLOGY
UROLOGY
Embedded Files
HAEMATURIA
HAEMATURIA
ABOUT THIS SESSION
ABOUT THIS SESSION
This is a self-directed learning resource designed to be worked through in the clinical environment.
Learning objectives:
Learning objectives:
Recognise causes of visible and non-visible haematuria
Understand key investigations in the diagnosis of haematuria
Understand management of visible haematuria in an inpatient setting
Total time:
50 minsNumber of students:
1-2Grade of students:
3rd to 5th year medical studentsCreated by:
Dr Charlotte HaydenUploaded:
27th August 2020Last updated:
27th August 2020Resources needed for this session:
Resources needed for this session:
Patient, pen, paper
Resources linked to this session:
Resources linked to this session:
Prostate conditions
Activity 1: History Taking and Examination
20 minActivity 1: History Taking and Examination
Find a patient presenting with visible or non-visible haematuria. Take a focused history around their presenting problem, remembering to ask about any associated symptoms and questions to differentiate between different causes. Explore their past medical, drug, social and family history.
Perform a focused abdominal examination plus any other examination(s) you feel are indicated.
Activity 2: Documentation and Diagnostic Reasoning
5 minActivity 2: Documentation and Diagnostic Reasoning
Document your findings in a systematic manner. You may want to use a local clerking proforma or have a look at this useful summary from Geeky Medics.
Write down 3-5 key differential diagnoses, with the most likely at the top. From this list, suggest one or two key features from the history and/or examination that makes each more and less likely.
Consider the following:
What are the most likely causes of visible haematuria and non-visible haematuria? List at least 3 causes of each. Highlight any pathologies you think could cause both visible and non-visible haematuria.
Are there any factors in the patient’s history that could make haematuria more likely? How might these factors affect your management?
Activity 3: Initial Investigations
15 minActivity 3: Initial Investigations
What investigations are indicated in a patient presenting with haematuria? Consider bedside tests, blood tests, urine tests, basic imaging and more complex imaging or specialist investigations.
Review the patient’s notes. Which of these investigations have they had? What did the results suggest?
If possible, attend a cystoscopy list (may be part of a one-stop haematuria clinic) to better understand this procedure. If this is not possible – find a video online. Practice explaining the procedure to a colleague as if they were a patient.
Activity 4: Specific Management
5 minActivity 4: Specific Management
Specific management depends on the cause of haematuria. Write down a suggested management plan for the patient you have seen.
Compare this with the patient’s notes.
Are there any differences?
If so, why might this be?
You may wish to discuss your ideas with a doctor caring for the patient.
Activity 5: Management of Severe Haematuria
5 minActivity 5: Management of Severe Haematuria
Consider the following questions:
What are the complications of severe haematuria?
How might this be managed? Consider supportive and local treatment options.
What is the role of bladder irrigation and bladder washouts?
How are these performed?
If possible, review a patient with a three-way catheter and/or irrigation system. Discuss with one of the nurses how this is managed.
Summary and Feedback
5 minSummary and Feedback
Highlight three key things you have learned today. Summarise them on a post-it note and keep it somewhere you will find in a week or two.
Found this useful? Please leave some feedback.
References and Further Reading
References and Further Reading
Page updated
Google Sites
Report abuse