MLA Domain 5 · Presentation
Haematuria
14 conditions in Finalist present this way. Work down the list and ask what would separate each one from the next — that discriminator is the exam question.
classic presentation · 5
Strongyloides HYPERINFECTION in the immunosuppressed (e.g. before starting steroids) → screen and treat first — it can b
Nephritic syndrome with rising creatinine → RPGN risk → nephrology/biopsy
Thrombosis from hyperviscosity
Sudden thunderclap headache → subarachnoid haemorrhage from a ruptured berry aneurysm → emergency
Obstruction + infection (fever/systemic upset) → EMERGENCY decompression (nephrostomy/stent) + antibiotics — the can't-m
recognised feature · 8
Acute urinary retention (painful, palpable bladder) → catheterise; high-pressure chronic retention with AKI → catheter +
Visible haematuria (any age) → urgent 2-week-wait referral; non-visible haematuria with risk factors/age → refer per NIC
Rapidly progressive GN — rising creatinine + active sediment ± haemoptysis (pulmonary-renal syndrome) → urgent immunolog
Severe abdominal pain (intussusception), GI bleeding, hypertension or significant proteinuria (renal involvement)
Acute S. aureus IE with valve destruction → heart failure/cardiogenic shock → emergency surgery
Metastatic spinal cord compression (back pain + neurology) → emergency MRI + dexamethasone + oncology
Visible haematuria → urgent referral (NICE NG12)
Fever, loin pain, rigors or systemic upset → pyelonephritis/urosepsis → escalate (see pyelonephritis)
differential of the above · 1