Haematuria: diagnostic approach — structured clinical encounter

Station 1 — recognition

The examiner asks what worries me about this child and how I frame the problem. I explain that cola-coloured urine with red-cell casts, dysmorphic red cells and proteinuria points to a glomerular source, and that the one to three week latency after a streptococcal throat infection points specifically to post-streptococcal glomerulonephritis. I confirm first that he is not in a hypertensive emergency, because his blood pressure is already at the limit and a nephritic child can deteriorate. I note that the colour and the cells together anchor the source before a single blood test returns. [8] [1]