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docnoor · Credits: 3871 My Scrapbook

Adolescent with hematuria and on investigation it was discovered to be idiopathic. next step?

a. renal biopsy.
b. IVP.
c. follow him up annually.
d. cystourethrogram.

smartyroy · Credits: 13861 My Scrapbook

? a........

sht · Credits: 1204 My Scrapbook

probably biopsy

Kai1111 · Credits: 2036 My Scrapbook

D) Cystourethrogram????

Need more info....is it microscopic hematuria or gross? I assume no h/o trauma or masturbation. The u/a confirms hematuria and doesn't show casts..... in which case I would get a renal sonogram. If that was neg, then a spiral CT, then a urethrogram.

I think this may be an old fashioned question, or for a situation in a rural setting in which case the answer might be urethrogram....I did consider IVP but this (http://www.emedicine.com/PED/topic951.htm) excellent source says "Intravenous urography rarely contributes additional in the evaluation of hematuria and may unnecessarily expose the child to ionizing radiation."

If it was just simple microsocopic hematuria, I'd check the urine once a week X3. ....most clear spontaneously and are due to inadvertent trauma. Need to also do some lab work to assess renal function, calcium levels, etc.

vanjik · Credits: 371 My Scrapbook

FU of UA on 1 month

IF (-) ----> REGULAR FU is OK

the most common ; benign recurrent hematuria
( usually runs in the family )

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