year old male patient brought to the emergency with passage of dark red urine since 4

today AM

# H. P. I

Onset of hematuria? How and when exactly

?Painless or painful

?Anything makes it worse or less

?Passage of clots in urine

fever, abdominal pain, dysuria, frequency, and recent enuresis ?

?Recent trauma to the abdomen

?Early-morning periorbital puffiness, weight gain, oliguria, edema or hypertension

?Recent throat or skin infection

?Skin rashes and arthritis

?Recent bladder catheterization

Loin pain? (ndicates ureteric obstruction)

Recent beet admission

# Systemic review

General (if there is a loss of appetite – fever-wight change – energy, sleep, mood changes)

- Focusing on the urinary system (dysuria – frequency passing urine

#Drug hx

recent drugs taken or in the past for a long time

does+major side effects + indication +duration +

# Past history

Previous episodes?and There time cource

?Any past problems in the urinary system

?Any major acute illnesses

?History of chronic illnesses

History of abdominal trauma ?

 ?recent bladder catheterization

?History of proteinuria

#Family hx

History of similar diseases in family members

?History of family diseases in the same system

History of chronic illnesses in family members

History of major acute illnesses

Congenital problems in family? Alport syndrome, collagen vascular diseases, urolithiasis, or

?polycystic kidney disease

Consangunity

Early deaths

# Socioeconomic history

Parents status

Living circumstances

Any smokers around

Pits

Insurance

#Perinatal hx

Maternal health during pregnancy

Gestational age at delivery + mode

Apgar score

NICU admissions

History of jaundice

Any illnesses during the first month

# Nutritional hx
 Was breast or bottled feeding + frequency + volume + if bottle how the milk is prepared

Age of weaning

Current intake and if he a peaky eater

Food allergies

vaccination history #

?When was the last vaccine

And the vaccination card

Any complications

Any special vaccines and why

Any contraindications for certain vaccine

# Px

General examination (vital signs heart rate, respiratory rate, temperatur(look for fever from
infection) blood pressure (look for hypertension)

Look for pallor from anemia

Signs of dehydration

Signs of respiratory distress (nasal flaring - use of accessory mussels)

.skin examination to look for rash or purpura

An abdominal examination to look for palpable kidneys (Wilms tumor or hydronephrotic

.kidneys)

examination of the genitalia

.ophthalmological evaluationin familial hematurias

Growth charts (statue - weight - head circumference) to assess growth and if there is failure
to thrive

# DDx

Acute Poststreptococcal Glomerulonephritis

Anti-GBM Antibody Disease

Hemolytic-Uremic Syndrome
 HSP

Hypercalciuria

Bacterial Endocarditis

IgA Nephropathy

Urinary Tract Infection

Urolithiasis

Reem saleh
123450
B7 group