Pigmenturia Flashcards

Flashcards based on the Pigmenturia lecture notes, focusing on key definitions, diagnostic approaches, and clinical case examples.

What is Pigmenturia?

Abnormal amounts of RBCs, hemoglobin, bilirubin, or other pigments in the urine.

What characterizes macroscopic pigmenturia?

Visible discoloration of urine; presenting complaint may include "bloody" or dark urine.

What are the characteristics of microscopic pigmenturia?

No visible discoloration of urine, but >5 RBCs per high-power field on microscopic examination, or a positive "blood" result on dipstick.

What is the primary goal when performing a urinalysis for suspected pigmenturia?

Differentiating intact RBCs from free pigments.

Name some causes of macroscopic hematuria in the upper urinary tract.

Renal neoplasia, trauma, acute bacterial pyelonephritis, calculi.

Name some causes of macroscopic hematuria in the lower urinary tract.

Infection, inflammation, feline idiopathic cystitis (FIC), calculi, neoplasia.

Name some systemic conditions associated with macroscopic hematuria due to hemoglobinuria.

Immune-mediated hemolytic anemia, disseminated intravascular coagulation, transfusion reaction, heat stroke.

What are some potential causes of myoglobinuria?

Severe crush injury, prolonged seizures.

What historical information is important to gather when investigating hematuria?

Dysuria/stranguria, pollakiuria, changes in urine stream, timing of hematuria, reproductive status, drug history.

What are some potential causes of hematuria accompanied by dysuria/stranguria?

Cystitis, urolithiasis, prostatitis, benign prostatic hyperplasia, neoplasia, trauma.

What are some potential causes of hematuria without dysuria?

Renal neoplasia, polycystic kidneys, trauma, nephroliths, pyelonephritis, idiopathic renal bleeding, glomerulonephritis, heat stroke, coagulopathy.

What are the key components of the physical exam when evaluating pigmenturia?

Observe urination, palpate kidneys and bladder, perform rectal and vaginal exams, and examine the prepuce/penis.

What are some key considerations when performing a urinalysis for pigmenturia?

Verify blood vs. pigment, identify iatrogenic hemorrhage, localize the source of bleeding, and check for bacteria, casts, and parasite eggs.

What can be assessed using radiographs in a pigmenturia case?

Assess kidney size and shape, prostate size and shape, and look for uroliths or lymph node abnormalities

What structures are typically evaluated during abdominal ultrasound for pigmenturia, and what specific abnormalities are you looking for?

Kidneys, bladder, and prostate, including FNA of cysts, masses, abscesses, and stones.

What are common causes of hemoglobinuria?

Immune-mediated hemolytic anemia, DIC, heat stroke, Caval syndrome (D. immitis), and other causes of hemolysis.

What are the key initial considerations when approaching a case of pigmenturia?

Blood vs. hemoglobin vs. myoglobin, upper or lower urinary tract signs.

What are the main differentials to consider when pigmenturia is accompanied by pollakiuria and stranguria?

Lower urinary tract disease, including infection, uroliths, neoplasia, and inflammation.

If a free catch urine sample has blood, but cystocentesis does not have blood what does that mean?

Problem is distal to the bladder (urethra, vagina, vestibule).