f******I
发帖数: 769 | 1
would be interested to know if there is any protein in the urine,
if there is no protein and no evidence of infection, then asymptomatic
isolated microscopic hematuria might not mean a whole much, as above reply
said could be from menses, or it could be from glomerular disease, so your
age, sex, other medical condition and what medications you are on would be
important,
to me, if you are relatively young with no significant health problems and
history and except the microscopic hematuria there |
|
f******I
发帖数: 769 | 2
if it's only microscopic hematuria alone without any symptoms then it's
probably nothing, but if there is proteins or casts in the urinalysis then
you need to work it up further,
common things causing hematuria include urinary tract infection and kidney
stones, or something more serious like nephritis, |
|
g***r
发帖数: 285 | 3
是能避免最好。
for any hematuria, you really have to try very hard to distinguish between
glomerular disease and extra-glomerular disease, if there is any red cell
cast, protein, abnomrally shaped red cells in the urine, then it's likely
glomerular disease and any further urological evaluation is not necessary
and you need to see a nephrologist,
assume you have painless microscopic hematuria, slightly elevated bilirubin,
all other labs and all other indices in urinalysis are normal, sounds like
urolog |
|
n***h
发帖数: 364 | 4 My answer is D.
该患者诊断： Nephrotic syndrome 。 依据：1） proteinuria 2）no hematuria.
另外容易形成静脉血栓（DVT）. PT has more cold is related to low albumin.
So B can be excluded first.
C(RPGN) and D(GOOD pasture) belong to Nephritic syndrome, should have
hematuria, so could be excluded ,too.
Answer A is Minimal Change Disease, a disease of nephrotic syndrome ,
but
usually affects children (peak incidence at 2–3 years of age).
So my answer is D(Membranoproliferative glomerulonephritis). |
|
f******I
发帖数: 769 | 5
microscopic hematuria could also be from urinary tract infection, |
|
f******I
发帖数: 769 | 6
晚。
you only provided very very limited information, basically 50 y/o male with
fever, hypotension, tachycardia, hematuria, orthopnea, history of some sort
of cardiac arrythmia and enlarged prostate, now with some signs of kidney,
cardiac dysfunction,
if you have the result of chest x-ray would be helpful for explaining why
orthopnea,
otherwise i'll guess septic shock from GU source, need urinanalysis and
blood culture to confirm that, need aggressive volume resuscitation and
broad spectrum anti |
|
f******I
发帖数: 769 | 7 if it's painless gross hematuria in an elderly, most likely need further
work up to rule out malignancy, |
|
f******I
发帖数: 769 | 8
you only provided very limited information, your urinalysis did not have any
results on WBC, nitrite, leukocyte estrase, bacteria count and such, which
are indications for infection, or if there is any casts in the urine, often
which indicates it's glomerular disease,
basically what you have is painless microscopic hematuria, as well as
proteinuria(even trace, unless transient, is always not a good thing to have
),
i think a CT and cystoscopy are a reasonable intial approach,
i don't think your |
|
f******I
发帖数: 769 | 9
epithelial
if you went to see an urologist, he's probably more concerned if it's stone
or structural abnormalities or malignancy, and he could care less about the
proteinuria as it's more of a medical issue than surgical issue, urologist
is specialized surgeon,
so far from what you provided there is no alarming signs of infection, and
if your hematuria/proteinuria persist then you might want to see a
nephrologist, a more specialized medicine doctor in kidney related disease,
should you have mor |
|
m****a
发帖数: 98 | 10 you got to do cystoscope, which can detect tiny tumor of the bladder.if you
have only hematuria w/t proteinuria, urologists are more appropriate than
nephrologists. |
|
l*******8
发帖数: 1745 | 11 在图书馆看书,正好看到这个.
希望对你母亲有点帮助.
After microscopic hematuria has been identified (2 of 3 urine samples with 3
or more RBC/hpf), the American urological Association recommends the
following evaluation: |
|
f****o
发帖数: 2770 | 12 Blood in the urine is a common problem. The medical term for red blood cells
in the urine is hematuria. Sometimes blood in the urine is a sign of a
serious problem in the urinary tract, while other times it is not serious
and requires no treatment. Only after a thorough evaluation by a health-care
provider should blood in the urine be attributed to a nonserious cause. |
|
c********e
发帖数: 496 | 13 hematuria in elder, first thing is to rule out malignancy, like bladder
cancer and renal cell carcinoma, then others. |
|
l**x
发帖数: 296 | 14 It's gonna be really expensive to work up hematuria in the US. If you want,
you can still take your father to county hospital and work it up and not
paying the bill.
Cancer needs to be ruled out as soon as possible. |
|
e****8
发帖数: 200 | 15 请问版上医生，无痛全程血尿是肾癌吗？
我父亲陪我妈来看黑色素瘤，可能自己也长期劳累过度；上上周二出现无痛全程血尿，
上上周三我们看了社区医院urgent care,np只做了尿检。安排上周三b超和周五见医生
。医生觉得b超和尿检不说明肾上有肿瘤，可是也无意解释全程血尿一般说明是肾上问
题。 urgent care医生约了泌尿科医生，但遥遥无期。也不允许我们做ct 检查。请求
专业人士给予指点。
1）b超中说cyst是囊肿还是肿瘤？“3.6cm cyst is noted in the lower pole. 9mm
nonobstructing calcification is noted in the mid to lower pole.” 3.6cm和钙
化是不是说明时肿瘤？
2）如果有肾肿瘤，b超是否可以发现？还是必须做增强ct？
3）如果是肾癌，这种情况是不是应该立刻回国手术？
家里悲剧一个接着一个，有点举足无措了。谢谢大家。。。
尿检结果如下：
标准值 测验值 项目名称
Component: Standard Range: Your V... 阅读全帖 |
|
T**7
发帖数: 264 | 16 请发给我：
你的
（1）简短的PUBLICATION LIST 不超过5篇文章
（2）你的名字
（3）学位
（4）EMAIL地址
Entitled "Asymptomatic bacteriuria increases the risk of edematous attacks
in hereditary angioedema due to C1-inhibitor deficiency"
Article Type: Original Article
Background: Although urinary tract infections are considered among the most
common infectious disorders in humans, these usually follow an uncomplicated
course. Various infections may have a role in inducing HAE attacks. Further
, danazol treatment has been associated ... 阅读全帖 |
|
D*****t
发帖数: 558 | 17 i know empty bladder is a common explanation provided by some drs. i don't
buy it. studies have shown that the source of most post-race hematuria (
bloody pee), up to 80% of the cases, is kidney, especially for marathoners.
distance running does cause temporary and reversible damage to the kidney.
this is evidenced by the fact that some marathoners have protein in their
urine also. i don't see how one can attribute proteinuria to an empty
bladder. |
|
j***y
发帖数: 5098 | 18 ☆─────────────────────────────────────☆
outbacker (IRUN) 于 (Sun Sep 25 21:13:15 2011, 美东) 提到:
跑步前别把尿尿的太空了。
膀胱很空的话，跑步时膀胱壁相互摩擦会出血，导致尿血。没什么大不了的，但会把男
人吓坏的，以为是肾的毛病。
☆─────────────────────────────────────☆
ryanflower (be myself) 于 (Sun Sep 25 21:23:00 2011, 美东) 提到:
尿血还能是这个原因啊。。。
☆─────────────────────────────────────☆
Rodimus (变叔- 都是浮云) 于 (Sun Sep 25 21:24:31 2011, 美东) 提到:
.............
☆─────────────────────────────────────☆
yuwenchengdu (宇文成都) 于 (Sun Sep 25 21:26:33 2011, 美东) 提到... 阅读全帖 |
|
c*******u
发帖数: 800 | 19 一个很不全面的小科普, 有错的话请见谅.
Feline lower urinary tract disease (FLUTD) 是一个症状相似但病因不同的疾病的
集合，最常见的症状是尿频，但每次的量很少，有时甚至会尿血。虽然症状类似，
FLUTD却能被分为截然不同的两类：obstructed和non-obstructed。常见病因包括：感
染(<3%, <10% 10-year or older)，结石(10-30%)，和idopathic(不明原因 ~60%)，和
肿瘤, 等。尿路感染 (urinary tract infection, UTI) 在猫里其实是比较少见的(狗
更常见). 因为感染和肿瘤相对比较少见, 下面就不讨论了.
Non-obstructed症状包括stranguria (排尿困难), pollakiuria (尿频但每次少尿),
painful urination (尿痛), hematuria (尿血), inappropriate urination (乱尿).
Obstructed症状除了上述之外还包括无法排尿和uremia (尿毒症). 区分non-
o... 阅读全帖 |
|
p********f
发帖数: 5148 | 20 结石是照了X光诊断的。照片resize后不知清晰程度如何。
检测结果如下：
color: yellow
clarity: cloudy
specific gravity: 1.012
glucose: 2+ Flag H
bilirubin: nagative
ketones: negative
blood: 3+ Flag H
PH: 6.5
Protein: 3+ (300-500 mg/dL) Protein test is performed and confirmed by the
sulfosalicylic acid test.
WBC:0-2
RBC:2-5
Bacteria: blank HPF moderate (9-40/HPF)
EPI cell: 1+ (1-2)
mucus: none seen
casts: none seen
crystals: none seen
other: non-crystalline debris present
urobilinogen: normal
UPC if i... 阅读全帖 |
|
t******e
发帖数: 1646 | 21 谢谢大家关心！ 已经回来了。 检查也没有结石也不是感染，确诊Hematuria,疑似
Feline Urological Syndrone。开了一小瓶Buprenex止痛镇静，一小瓶Prazosin舒张尿
路肌肉。
解释了引起FLUTD的各种原因，饮食、环境给了一些建议。让接回家密切观察。。。也
不知道晚上这胶囊药丸要怎么喂给这掰不开嘴的夺猫。。。
附一张X-ray，说是The bladder had an increased opacity which may represent a
large amount of urine sediment. 看来以后还是改喝纯净水得了，还要想办法看看怎
么让这倔强挑食猫改吃罐头。。 |
|
p****n
发帖数: 9263 | 22 Adverse ReactionsBased upon normal doses for either indication or route. (
Adverse effects such as flushing, diarrhea, myalgia, and visual disturbances
may be increased with doses >100 mg/24 hours.)
>10%:
Central nervous system: Headache (16% to 46%)
Gastrointestinal: Dyspepsia (7% to 17%; dose related)
2% to 10%:
Cardiovascular: Flushing (10%)
Central nervous system: Insomnia (≤7%), pyrexia (6%), dizziness (2%)
Dermatologic: Erythema (6%), rash (2%)
Gastrointestinal: Diarrhea (3% to 9%), gastri... 阅读全帖 |
|
k**e
发帖数: 2728 | 23 ☆─────────────────────────────────────☆
Mcdoudou (laowu) 于 (Fri Sep 10 01:50:41 2010, 美东) 提到:
看这个版也有几年了，一直觉得这个版挺和谐，有很多有用的帖子。我一般不大记得住
ID, 能记住的有老刀，acne, teabao, Eric， 还有一个前版主（个人偶像：此人在IT
浪潮时下海做了码工，考板热时成功考板match, 不记得ID了，只记得他的头像是他女
儿，极cute）。不过最近有点乱，有英语语法癖 （个人很反感，尽量跳过，跳不过就
只好当吃苍蝇了），有26岁问自己是不是太老的（use you common sense, please），
这不又有99er考经是不是炫耀贴。平心而论，有些是有一些炫耀的意味在里面。不过呢
，一是有可能不经意的，二是不影响交流。现在可好，有人抱怨一下，有人砸，乱了套
了。现在我带头发一下我的非99er考经和不成功的match经历。
个人情况：male, 老CMG, (15+), Ph.D无绿卡。
Step1: 06年3月底ebay拍到Kaplan ... 阅读全帖 |
|
p******9
发帖数: 114 | 24 1. A 5-year-old boy is brought to the physician 1 hour after urinating
bright red blood. He has been taking ibuprofen since injuring his right
flank while wrestling with friends yesterday; he also has been taking
penicillin for 3 days for streptococcal pharyngitis. His temperature is 36.7
C (98 F), blood pressure is 90/48mm Hg, pulse is 108/min, and respirations
are 18/min. Examination shows purple ecchymoses over the shins and right
flank; there is tenderness of the right costovertebral area. T... 阅读全帖 |
|
L********a
发帖数: 576 | 25 A 42 year old man is admitted to the local hospital with a diagnosis of deep
vein thrombosis. On physical exam, he has bilateral pitting edema of the
lower extremities. On standard chemistry testing, his albumin is 2.5g/dl.
During further interview, the patient states that this past year he noticed
he had more "cold" than usual. A 24 hour urinalysis shows 4 g of protein
with no hematuria or red blood cells. If a renal biopsy is performed, which
of the following findings would be expected?
A) Nor... 阅读全帖 |
|
L********a
发帖数: 576 | 26 The answer in Kaplan is A. I don't know why. But IgA nephritis should be hematuria only, this patient also have proteinuria. |
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g*******n
发帖数: 319 | 27 found this on the internet, I feel it's kind of helpful for me so just want
to share with you guys:
Features of nephrotic syndrome - "NAPHROTIC"
Na+ - you may rarely get hyponatremia in nephrotic syndrome; this is also a
reminder that there is an intense pathophysiologic retention of sodium due
to reduced oncotic pressure
Albumin - serum levels are decreased
Proteinuria >3g/day
Hyperlipidemia
Renal vein thrombosis
Oedema
Thrombosis
Infections - more prone to them due to loss of Ig in the urine
... 阅读全帖 |
|
n*****n
发帖数: 119 | 28 别处看到的，觉得还不错，不排除有些拼写错误~
POMR (Problem-Oriented Medical Records)表格式住院病历
Biographical data:
一般项目：
Name Age Sex Marital status Nativity Race
姓名 年龄 性别 婚否 籍贯 民族
Occupation Date of admission Informant History
职业 入院日期 病史叙述者 病史
Chief complaint
主诉
History of present illness
现病史
Past history
既往史：
Previous health status: well ordinary bad Infectious diseases
平素健康状况： 良好 一般 较差 传染病史
Immunizations Allergies: N Y clinical manifestation
预防接种史 过敏史 无 有 临床表现
allergen: Trauma: Surgery:
过敏原 外伤... 阅读全帖 |
|
e****0
发帖数: 678 | 29 • Exaggerated deep tendon reflexes can be seen in lock in syndrome.
• Non bleeding varices are managed with nonselective beta-
adrenergic antagonists, such as propranolol.
• Sclerotherapy, endoscopic band ligation, and surgery are
indicated after a patient has a first episode of variceal bleeding.
• TIPS is a last resort in variceal bleeding unresponsive to
medical and endoscopic intervention.
• Ischemic colitis
CT—thickening of eth bowel ... 阅读全帖 |
|
R*******t
发帖数: 367 | 30 I assume the patient has hematuria. Plain film KUB is very low yield for
that and the patient needs a CT anyway. So many clinicians skip the plain film. Plain film KUBs can be used to follow up
known nephroliths.
doesn |
|
s******v
发帖数: 477 | 31 Send her to emergency room right away.
There are many causes of hypotension, like heart attack ( may or may not
have chest pain), sepsis,bleeding, dehydration...... Hypotension is
dangerous, especially for elder patients. According to your post she has
hematuria and hypotension, urinary track infection, tumor, and nephrotic
syndrome have to been rule out.
Don't treat her home. Send her to emergency room NOW!!! |
|
m********e
发帖数: 148 | 32 Very good summary. Doubt to be IgAN since not much hematuria.
Skin infection 2 months ago. Post infectious GN highly likely. Other ddx as
you said. Absolutely need renal biopsy ASAP.
Rx: Steroid, bumex/lasix/torsemide, ACE-I/ARB and statin. Cytotoxic agent
may need in future pending on serology and biopsy.
Should see a nephrologist ASAP. There are some cases of staphy caused GN
reported in recent literature.
Best wish-such a young 26 yo. |
|
t*********m
发帖数: 360 | 33 An elderly Chinese man with painless microscopic hematuria. I assume that we
are NOT talking about occult blood in urine, right?
Basically, it could be anything which causes damage of small blood vessels.
By statistics, probably goes to BPH. By grave outcomes, it goes to tumor.
No matter how imaginative physicians are, we need facts.
He will/probably had studies by a Urologist,not a nephrologist.
Stone should be easily excluded by an ultrasound. The time- 2years, seems
not to favor tumor, but ca... 阅读全帖 |
|
