| What types of pain can occur alongside blood in the urine? | Pain during voiding (urethra) • Pain in suprapubic region (bladder) • Pain in flank (kidney) | SYMPTOMS • Blood in urine - red coloured or dark coloured • May be associated with pain: • Pain during voiding (urethra) • Pain in suprapubic region (bladder) • Pain in flank (kidney) • Acute retention of urine due to clots RISK FACTORS • Age > 40 years and male gender • Smoking • Occupational exposure (Textile, Chemicals, Rubber, Dye, Printing) • Family History of Genitourinary malignancy • Personal history of contact with tuberculosis • History of stone disease • Recurrent UTI EXAMINATION • Pulse, blood pressure • Check for pallor • Check for anasarca • Per abdomen examination: Palpable bladder, flank mass • Digital rectal examination: Enlarged prostate, hard nodular/ smooth surfaced prostate • Rule out vaginal causes of bleeding | 91 | list | 0.820 | SYMPTOMS • Blood in urine - red coloured or dark coloured • May be associated with pain: • Pain during voiding (urethra) • Pain in suprapubic region (bladder) • Pain in flank (kidney) • Acute retention of urine due to clots RISK FACTORS • Age > 40 years and male gender • Smoking • Occupational exposure (Textile, Chemicals, Rubber, Dye, Printing) • Family History of Genitourinary malignancy • Personal history of contact with tuberculosis • History of stone disease • Recurrent UTI EXAMINATION • Pulse, blood pressure • Check for pallor • Check for anasarca • Per abdomen examination: Palpable | 1 | page=1,block=5 | 0.700 | valid |
| What are the signs that may suggest a urinary tract infection? | dysuria, increased frequency of voiding and other irritative lower urinary tract symptoms with/ without fever | • Start intravenous fluids if required • If Anaemia - may transfuse blood as required • Manage clot colic /flank pain with analgesics • If Acute urinary retention - catheterise with 20/22Fr 3 way Foley and may start continuous irrigation with normal saline SPECIFIC • Suspect urinary tract infection : presents with dysuria, increased frequency of voiding and other irritative lower urinary tract symptoms with/ without fever- treat with broad spectrum oral antibiotics • Cystoscopic clot evacuation may be performed if feasible • If basic evaluation and management facilities are unavailable SPECIFIC • Haematuria should be considered as a symptom of genitourinary malignancy in patients >40years old until proven otherwise • Suspected nephrotic/nephritic syndrome: cola coloured urine, proteinuria, anasarca, hypertension - Refer to nephrologist PHC/DH (GENERAL) | 316 | list | 0.820 | • Start intravenous fluids if required • If Anaemia - may transfuse blood as required • Manage clot colic /flank pain with analgesics • If Acute urinary retention - catheterise with 20/22Fr 3 way Foley and may start continuous irrigation with normal saline SPECIFIC • Suspect urinary tract infection : presents with dysuria, increased frequency of voiding and other irritative lower urinary tract symptoms with/ without fever- treat with broad spectrum oral antibiotics • Cystoscopic clot evacuation may be performed if feasible • If basic evaluation and management facilities are unavailable |
| What are the key initial tests for evaluating kidney or urinary bladder problems? | Urine examination - routine, microscopy • Complete Hemogram • Kidney function tests (KFT) • Ultrasonography of kidney urinary bladder and prostate region | • Deranged kidney functions • Suspecting malignancy • Haematuria with hypertension / albuminuria • Persistent severe haematuria WHEN TO REFER (WARNING SIGNS) ESSENTIAL • Urine examination - routine, microscopy • Complete Hemogram • Kidney function tests (KFT) • Ultrasonography of kidney urinary bladder and prostate region DESIRABLE • Contrast enhanced computed tomography of kidney urinary bladder region/ intravenous pyelography (if KFT normal) • Magnetic resonance imaging of Kidney urinary bladder region (if KFT deranged) • Urine cytology if > 40yrs or smoker • Cystoscopy if > 40 years or smoker OPTIONAL • Urine culture • Urine for active sediments(if nephrotic/ nephritic syndrome suspected) • PT/INR (if bleeding disorder suspected) • Serum prostate specific antigen (if required) • Urine for acid fast bacilli - 3 samples (if tuberculosis suspected) INITIAL • Urethra: stone, urethritis, stricture • Prostate: inflammation, benign hyperplasia, malignancy TOTAL • Kidney: stone, malignancy (renal parenchyma, pelvis/ureter, genito-urinary tuberculosis • Ureter: stone, malignancy, genito- urinary tuberculosis • Bladder: infection, genitourinary tuberculosis, stone, malignancy) TERMINAL • Bladder: stone, tumor at bladder neck • Prostate: inflammation, benign hyperplasia, malignancy |
| What are the symptoms associated with blood in urine? | red coloured or dark coloured | SYMPTOMS • Blood in urine - red coloured or dark coloured • May be associated with pain: • Pain during voiding (urethra) • Pain in suprapubic region (bladder) • Pain in flank (kidney) • Acute retention of urine due to clots RISK FACTORS • Age > 40 years and male gender • Smoking • Occupational exposure (Textile, Chemicals, Rubber, Dye, Printing) • Family History of Genitourinary malignancy • Personal history of contact with tuberculosis • History of stone disease • Recurrent UTI EXAMINATION • Pulse, blood pressure • Check for pallor • Check for anasarca • Per abdomen examination: Palpable bladder, flank mass • Digital rectal examination: Enlarged prostate, hard nodular/ smooth surfaced prostate • Rule out vaginal causes of bleeding | 28 | list | 0.820 | SYMPTOMS • Blood in urine - red coloured or dark coloured • May be associated with pain: • Pain during voiding (urethra) • Pain in suprapubic region (bladder) • Pain in flank (kidney) • Acute retention of urine due to clots RISK FACTORS • Age > 40 years and male gender • Smoking • Occupational exposure (Textile, Chemicals, Rubber, Dye, Printing) • Family History of Genitourinary malignancy • Personal history of contact with tuberculosis • History of stone disease • Recurrent UTI EXAMINATION • Pulse, blood pressure • Check for pallor • Check for anasarca • Per abdomen examination: Palpable |
| What are the possible causes of pain during urination? | Pain during voiding (urethra) • Pain in suprapubic region (bladder) • Pain in flank (kidney) | SYMPTOMS • Blood in urine - red coloured or dark coloured • May be associated with pain: • Pain during voiding (urethra) • Pain in suprapubic region (bladder) • Pain in flank (kidney) • Acute retention of urine due to clots RISK FACTORS • Age > 40 years and male gender • Smoking • Occupational exposure (Textile, Chemicals, Rubber, Dye, Printing) • Family History of Genitourinary malignancy • Personal history of contact with tuberculosis • History of stone disease • Recurrent UTI EXAMINATION • Pulse, blood pressure • Check for pallor • Check for anasarca • Per abdomen examination: Palpable bladder, flank mass • Digital rectal examination: Enlarged prostate, hard nodular/ smooth surfaced prostate • Rule out vaginal causes of bleeding | 91 | list | 0.820 | SYMPTOMS • Blood in urine - red coloured or dark coloured • May be associated with pain: • Pain during voiding (urethra) • Pain in suprapubic region (bladder) • Pain in flank (kidney) • Acute retention of urine due to clots RISK FACTORS • Age > 40 years and male gender • Smoking • Occupational exposure (Textile, Chemicals, Rubber, Dye, Printing) • Family History of Genitourinary malignancy • Personal history of contact with tuberculosis • History of stone disease • Recurrent UTI EXAMINATION • Pulse, blood pressure • Check for pallor • Check for anasarca • Per abdomen examination: Palpable |
| What are the warning signs that require referral for further evaluation? | Deranged kidney functions • Suspecting malignancy • Haematuria with hypertension / albuminuria • Persistent severe haematuria | • Deranged kidney functions • Suspecting malignancy • Haematuria with hypertension / albuminuria • Persistent severe haematuria WHEN TO REFER (WARNING SIGNS) ESSENTIAL • Urine examination - routine, microscopy • Complete Hemogram • Kidney function tests (KFT) • Ultrasonography of kidney urinary bladder and prostate region DESIRABLE • Contrast enhanced computed tomography of kidney urinary bladder region/ intravenous pyelography (if KFT normal) • Magnetic resonance imaging of Kidney urinary bladder region (if KFT deranged) • Urine cytology if > 40yrs or smoker • Cystoscopy if > 40 years or smoker OPTIONAL • Urine culture • Urine for active sediments(if nephrotic/ nephritic syndrome suspected) • PT/INR (if bleeding disorder suspected) • Serum prostate specific antigen (if required) • Urine for acid fast bacilli - 3 samples (if tuberculosis suspected) INITIAL • Urethra: stone, urethritis, stricture • Prostate: inflammation, benign hyperplasia, malignancy TOTAL • Kidney: stone, malignancy (renal parenchyma, pelvis/ureter, genito-urinary tuberculosis • Ureter: stone, malignancy, genito- urinary tuberculosis • Bladder: infection, genitourinary tuberculosis, stone, malignancy) TERMINAL • Bladder: stone, tumor at bladder neck • Prostate: inflammation, benign hyperplasia, malignancy |
| What tests are considered essential for initial evaluation of kidney and urinary bladder issues? | Urine examination - routine, microscopy • Complete Hemogram • Kidney function tests (KFT) • Ultrasonography of kidney urinary bladder and prostate region | • Deranged kidney functions • Suspecting malignancy • Haematuria with hypertension / albuminuria • Persistent severe haematuria WHEN TO REFER (WARNING SIGNS) ESSENTIAL • Urine examination - routine, microscopy • Complete Hemogram • Kidney function tests (KFT) • Ultrasonography of kidney urinary bladder and prostate region DESIRABLE • Contrast enhanced computed tomography of kidney urinary bladder region/ intravenous pyelography (if KFT normal) • Magnetic resonance imaging of Kidney urinary bladder region (if KFT deranged) • Urine cytology if > 40yrs or smoker • Cystoscopy if > 40 years or smoker OPTIONAL • Urine culture • Urine for active sediments(if nephrotic/ nephritic syndrome suspected) • PT/INR (if bleeding disorder suspected) • Serum prostate specific antigen (if required) • Urine for acid fast bacilli - 3 samples (if tuberculosis suspected) INITIAL • Urethra: stone, urethritis, stricture • Prostate: inflammation, benign hyperplasia, malignancy TOTAL • Kidney: stone, malignancy (renal parenchyma, pelvis/ureter, genito-urinary tuberculosis • Ureter: stone, malignancy, genito- urinary tuberculosis • Bladder: infection, genitourinary tuberculosis, stone, malignancy) TERMINAL • Bladder: stone, tumor at bladder neck • Prostate: inflammation, benign hyperplasia, malignancy |
| What are the symptoms of blood in urine that may be associated with pain? | Pain during voiding (urethra) • Pain in suprapubic region (bladder) • Pain in flank (kidney) | SYMPTOMS • Blood in urine - red coloured or dark coloured • May be associated with pain: • Pain during voiding (urethra) • Pain in suprapubic region (bladder) • Pain in flank (kidney) • Acute retention of urine due to clots RISK FACTORS • Age > 40 years and male gender • Smoking • Occupational exposure (Textile, Chemicals, Rubber, Dye, Printing) • Family History of Genitourinary malignancy • Personal history of contact with tuberculosis • History of stone disease • Recurrent UTI EXAMINATION • Pulse, blood pressure • Check for pallor • Check for anasarca • Per abdomen examination: Palpable bladder, flank mass • Digital rectal examination: Enlarged prostate, hard nodular/ smooth surfaced prostate • Rule out vaginal causes of bleeding | 91 | list | 0.820 | SYMPTOMS • Blood in urine - red coloured or dark coloured • May be associated with pain: • Pain during voiding (urethra) • Pain in suprapubic region (bladder) • Pain in flank (kidney) • Acute retention of urine due to clots RISK FACTORS • Age > 40 years and male gender • Smoking • Occupational exposure (Textile, Chemicals, Rubber, Dye, Printing) • Family History of Genitourinary malignancy • Personal history of contact with tuberculosis • History of stone disease • Recurrent UTI EXAMINATION • Pulse, blood pressure • Check for pallor • Check for anasarca • Per abdomen examination: Palpable |
| What occupational exposures are considered risk factors for certain conditions? | Textile, Chemicals, Rubber, Dye, Printing | SYMPTOMS • Blood in urine - red coloured or dark coloured • May be associated with pain: • Pain during voiding (urethra) • Pain in suprapubic region (bladder) • Pain in flank (kidney) • Acute retention of urine due to clots RISK FACTORS • Age > 40 years and male gender • Smoking • Occupational exposure (Textile, Chemicals, Rubber, Dye, Printing) • Family History of Genitourinary malignancy • Personal history of contact with tuberculosis • History of stone disease • Recurrent UTI EXAMINATION • Pulse, blood pressure • Check for pallor • Check for anasarca • Per abdomen examination: Palpable bladder, flank mass • Digital rectal examination: Enlarged prostate, hard nodular/ smooth surfaced prostate • Rule out vaginal causes of bleeding | 305 | list | 0.820 | SYMPTOMS • Blood in urine - red coloured or dark coloured • May be associated with pain: • Pain during voiding (urethra) • Pain in suprapubic region (bladder) • Pain in flank (kidney) • Acute retention of urine due to clots RISK FACTORS • Age > 40 years and male gender • Smoking • Occupational exposure (Textile, Chemicals, Rubber, Dye, Printing) • Family History of Genitourinary malignancy • Personal history of contact with tuberculosis • History of stone disease • Recurrent UTI EXAMINATION • Pulse, blood pressure • Check for pallor • Check for anasarca • Per abdomen examination: Palpable |
| What are the essential initial investigations for suspected kidney or urinary bladder issues? | Urine examination - routine, microscopy • Complete Hemogram • Kidney function tests (KFT) • Ultrasonography of kidney urinary bladder and prostate region | • Deranged kidney functions • Suspecting malignancy • Haematuria with hypertension / albuminuria • Persistent severe haematuria WHEN TO REFER (WARNING SIGNS) ESSENTIAL • Urine examination - routine, microscopy • Complete Hemogram • Kidney function tests (KFT) • Ultrasonography of kidney urinary bladder and prostate region DESIRABLE • Contrast enhanced computed tomography of kidney urinary bladder region/ intravenous pyelography (if KFT normal) • Magnetic resonance imaging of Kidney urinary bladder region (if KFT deranged) • Urine cytology if > 40yrs or smoker • Cystoscopy if > 40 years or smoker OPTIONAL • Urine culture • Urine for active sediments(if nephrotic/ nephritic syndrome suspected) • PT/INR (if bleeding disorder suspected) • Serum prostate specific antigen (if required) • Urine for acid fast bacilli - 3 samples (if tuberculosis suspected) INITIAL • Urethra: stone, urethritis, stricture • Prostate: inflammation, benign hyperplasia, malignancy TOTAL • Kidney: stone, malignancy (renal parenchyma, pelvis/ureter, genito-urinary tuberculosis • Ureter: stone, malignancy, genito- urinary tuberculosis • Bladder: infection, genitourinary tuberculosis, stone, malignancy) TERMINAL • Bladder: stone, tumor at bladder neck • Prostate: inflammation, benign hyperplasia, malignancy |