Notes on Hematuria:

Red urine is not always caused by hematuria. A variety of medications, food dyes, and metabolites can cause heme-negative red urine, or pigmenturia. Furthermore, not all dipstick tests positive for blood are due to hematuria. In addition to detecting heme in intact red blood cells (RBCs), urine dipsticks detect free hemoglobin (commonly associated with hemolytic anemia) and myoglobin (commonly associated with rhabdomyolysis), hence leading to false-positive tests for hematuria.

Whenever the urine dipstick is positive for blood, and the microscopic exam of the urine does not show RBCs, myoglobinuria and hemoglobinuria should be considered.

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Bot:

من ضمنهم الشوندر (beets) ممكن يسبب ادرار لونه وردي مائل للحمر لأن بيه محتوى عالي من الصبغات واكو بعض الادوية تناولها هم يسبب discoloration of urine but I forgot the names
فالمحللين الي يشتغلون بالمختبرات.. questioner is important for the patient when we do these tests (especially the urine test) before we can give any conclusion by ourselves

يب صحيح
أدوية مثل ال phenazopyridine (مسكن آلام يستخدموه لآلام الجهاز البولي بالتحديد)، وال rifampin ويمكن حتى الفلاجيل (metronidazole)

Wilms tumor, or nephroblastoma:
is the most common renal cancer in the pediatric age group. It is also the most common pediatric abdominal cancer and the fourth most common pediatric cancer overall. 
Wilms tumor is typically found in children younger than five years old. The tumor is named after the German physician, Dr. Max Wilms, who first described it in 1899.

A 4-year-old boy was presented with right side abdominal distension and discomfort. Before that, haematuria with clots occurred intermittently and the child cried at each time of urination. That is reason the parents brought him to Children’s Hospital.

On examination:
The child’s skin looked normal,
well-nourished and apyrexial,
the abdomen was soft and not tender. At the right-side of the abdominal wall was a mass with freely movable and smooth edges. It easily palpated above and below the mass.
At the time of the clinical exam, they had to consider 4 potential diagnoses that differentiate:
(1) Wilms’ Tumor
(2) Neuroblastoma
(3) Polycystic kidney disease
(4) Rhabdomyosarcoma.

This was confirmed more by histology.

Wilms’ tumor can also run in families, although this is rare. When the child was diagnosed as Wilms’ tumors, tests can be done on parents. Screening for Wilms’ tumor is very important for children because it relates to child survival. To find kidney tumors when they are still small and have not yet spread to other organs can save their life in 4 years. Therefore, screening for Wilms’ tumor is very important for the child who has syndromes, or birth defects, or a family history.
A very simple and cheap way is for physical exams to be done by a specialist, ultrasound on a regular basis is recommended, it could be done on a 3- 4 months interval until the child reaches age of 8 years old.

+ its common metastasis is: the other kidney and lung.

Bot:

Nitrofurantoin (UT local antiseptic)
ايضا يسبب تغيير بلون الادرار جوزي مائل للاحمرار

البارحة شكد ردت اتذكره وما كدرت :")

There is a saying about surgeons, meant as a reproof: “Sometimes wrong; never in doubt.” But this seemed to me their strength. Every day, surgeons are faced with uncertainties. Information is inadequate; the science is ambiguous; one’s knowledge and abilities are never perfect. Even with the simplest operation, it cannot be taken for granted that a patient will come through better off—or even alive.

- Complications: A surgeon's notes on an imperfect science

🐈‍⬛ INH (isoniazid) is similar to B6 structure, thus it can bind and inhibit pyridoxine phosphokinase (which makes active B6 - pyridoxal phosphate (PLP); thus Niacin cannot be synthesized from Tryptophan (requires PLP)

- carcinoid Tumors use massive amounts of tryptophan to make serotonin, stealing tryptophan away from making niacin

Okay, wait
So INH can cause pellagra cuz it inhibits the enzyme that makes active B6, which is required for making niacin?

Yeah 😂

I know a guy who knows a guy who knows another guy

Exactlyyy😂
+ That's exactly what I love about medicine

That’s why TB patients who are given INH should also be supplemented with pyridoxine.