Haematuria assessment — structured viva

Structured oral on haematuria: the visibility triage with Price's odds ratios and PPVs, confirmation discipline, AUA risk tiers with incidence numbers, cytology's demotion, glomerular versus urological routing, and the traps — treated UTIs, anticoagulation, exercise.

Prompt

The examiner opens: 'A 55-year-old smoker phones in saying he saw blood in his urine once, last week. He feels fine. What are you going to do?' The viva branches through the initial response, confirmation rules, risk stratification with trial numbers, investigation sequencing, the glomerular fork, and benign mimics.

Stem

One episode of visible blood in a 55-year-old smoker's urine. No pain, no other symptoms. The phone call is your only warning before he decides it was nothing. ^[3]

References9Show

[3]Price SJ, Shephard EA, Stapley SA et al. Non-visible versus visible haematuria and bladder cancer risk: a study of electronic records in primary care. The British journal of general practice : the journal of the Royal College of General Practitioners, 2014.PMID 25179073
[2]Grossfeld GD, Wolf JS Jr, Litwan MS et al. Asymptomatic microscopic hematuria in adults: summary of the AUA best practice policy recommendations. American family physician, 2001.PMID 11277551
[5]Woldu SL, Ng CK, Loo RK et al. Evaluation of the New American Urological Association Guidelines Risk Classification for Hematuria. The Journal of urology, 2021.PMID 33356483
[4]Tan WS, Sarpong R, Khetrapal P et al. Does urinary cytology have a role in haematuria investigations? BJU international, 2019.PMID 30003675
[6]Khadhouri S, Gallagher KM, MacKenzie KR et al. Developing a Diagnostic Multivariable Prediction Model for Urinary Tract Cancer in Patients Referred with Haematuria: Results from the IDENTIFY Collaborative Study. European urology focus, 2022.PMID 35760722
[9]Malik T, Denfhy J, Theinkha Lin H et al. Multicentre real-world evaluation of the Haematuria Cancer Risk Score to risk-stratify the detection of bladder cancer in patients referred from primary care. BJUI compass, 2026.PMID 42256644
[8]Floege J, Fervenza FC, Coppo R Microscopic hematuria in IgA nephropathy: a biomarker of disease activity. Clinical kidney journal, 2026.PMID 41704425
[1]Gambrell RC, Blount BW Exercised-induced hematuria. American family physician, 1996.PMID 8594866
[10]Tsili AC, Varkarakis I, Pasoglou V et al. CT of the urinary tract revisited. European journal of radiology, 2023.PMID 36773595

Haematuria assessment — structured viva

Stem

One episode of visible blood in a 55-year-old smoker's urine. No pain, no other symptoms. The phone call is your only warning before he decides it was nothing. ^[3]

References9Show

[3]Price SJ, Shephard EA, Stapley SA et al. Non-visible versus visible haematuria and bladder cancer risk: a study of electronic records in primary care. The British journal of general practice : the journal of the Royal College of General Practitioners, 2014.PMID 25179073
[2]Grossfeld GD, Wolf JS Jr, Litwan MS et al. Asymptomatic microscopic hematuria in adults: summary of the AUA best practice policy recommendations. American family physician, 2001.PMID 11277551
[5]Woldu SL, Ng CK, Loo RK et al. Evaluation of the New American Urological Association Guidelines Risk Classification for Hematuria. The Journal of urology, 2021.PMID 33356483
[4]Tan WS, Sarpong R, Khetrapal P et al. Does urinary cytology have a role in haematuria investigations? BJU international, 2019.PMID 30003675
[6]Khadhouri S, Gallagher KM, MacKenzie KR et al. Developing a Diagnostic Multivariable Prediction Model for Urinary Tract Cancer in Patients Referred with Haematuria: Results from the IDENTIFY Collaborative Study. European urology focus, 2022.PMID 35760722
[9]Malik T, Denfhy J, Theinkha Lin H et al. Multicentre real-world evaluation of the Haematuria Cancer Risk Score to risk-stratify the detection of bladder cancer in patients referred from primary care. BJUI compass, 2026.PMID 42256644
[8]Floege J, Fervenza FC, Coppo R Microscopic hematuria in IgA nephropathy: a biomarker of disease activity. Clinical kidney journal, 2026.PMID 41704425
[1]Gambrell RC, Blount BW Exercised-induced hematuria. American family physician, 1996.PMID 8594866
[10]Tsili AC, Varkarakis I, Pasoglou V et al. CT of the urinary tract revisited. European journal of radiology, 2023.PMID 36773595