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Flashcards in DIFFERENTIAL DIAGNOSIS Deck (15)
1

What is the pathophysiological cause of renal pain?

Distension of the renal capsule due to obstruction or inflammation.

2

How might renal pain differ in character between obstruction and inflammation?

Obstruction - colicky pain as ureteric peristalsis increases renal pelvic pressure

Inflammation - steady pain

3

What is the differential diagnosis for flank pain?

Obstructive:

Obstruction of ureteropelvic junction
Renal stones
Tumours
Schistosomiasis
Renal clots (iatrogenic)
Papillary necrosis
Retroperitoneal fibrosis

Inflammation:

Pyelonephritis
Renal abscess
Papillary necrosis
Polycystic kidney disease
Acute renal infarct

Non-renal:

AAA
Pneumonia
Musculoskeletal

4

How much fluid needs to build up in the bladder before pain is felt as a result of retention?

This is not dependent on volume but more on timescale. Slowly progressive obstruction causing chronic retention is painless despite residuals of over 1 litre.

5

What is the differential diagnosis for bladder pain?

Interstitial cystitis

UTI

Bladder cancer

Acute retention

Renal stones

6

What is the differential diagnosis for testicular pain?

Acute:

Epididymo-orchitis
Testicular torsion
Trauma
Mumps

Chronic:

Varicocele
Spermatocele
Testicular cancer
Benign testicular masses
Retractile testicle
Cryptorchidism (undescended testicle)
Hydrocele

7

How do we split up the causes of haematuria?

Innocent (pseudohaematuria)

Pre-renal

Renal

Post-renal - Ureteric / Bladder / Prostatic / Urethral

8

What are the innocent causes of apparent haematuria?

Haemoglobinuria

Myoglobinuria

Menstruation

Sexual intercourse

Acute intermittent porphyria

Beetroot, blackberries, rhubarb

Drugs: nitrofurantoin, senna, rifampicin, chloroquine and doxorubicin

9

What are the pre-renal causes of haematuria?

Bleeding diathesis

Atrial fibrillation - warfarin therapy and embolism

Infective endocarditis

Scurvy

Purpura

Leukaemia

Thrombocytopenia

Haemophilia

10

What are the renal causes of haematuria?

IgA nephropathy

Glomerulonephritis

Polyarteritis nodosa

Goodpasture's syndrome

Acute pyelonephritis

Polycystic kidney disease

Haemolytic uremic syndrome

Alport's syndrome

11

What are ureteric causes of haematuria?

Calculus

Carcinoma

Papilloma

Schistosomiasis

12

What are the bladder related causes of haematuria?

Cancer

Calculus

Cystitis

Injury

Purpura

Schistosomiasis

Ketamine

13

What are the prostatic causes of haematuria?

BPH

Cancer

14

What are the urethral causes of haematuria?

Acute urethritis

Calculus

Injury

Carcinoma

Papilloma

Urethral meatal ulcer

Foreign body

15

What is a good question to ask in the history to rule out organic causes of erectile dysfunction?

Early morning erections