№ 10Differential Diagnostic Topics16 min read
Differential diagnosis of hematuria
1. Big picture
Hematuria = blood in the urine. In an exam, the main task is not only to list causes, but to answer:
Is the bleeding glomerular, renal non-glomerular, or urological?
This decides the referral pathway:
Red urine
↓
Confirm true hematuria by microscopy
↓
RBC morphology + proteinuria + casts?
↓
Glomerular → nephrology
Non-glomerular/urological → urology
The dangerous diagnoses not to miss are:
- Urothelial/bladder cancer
- Renal cell carcinoma
- Nephritic syndrome / rapidly progressive glomerulonephritis
- Infected obstructing stone
- Trauma
- Severe anticoagulant-related bleeding
- Papillary necrosis
- **Tuberculosis
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