**Question:** Features of glomerular haematuria -

A. Presence of red blood cells in the urine
B. Increased filtration rate
C. Proteinuria
D. Altered urinary sediment

**Core Concept:** Glomerular haematuria refers to the presence of red blood cells (RBCs) in the urine, which can be due to various causes affecting the glomerular filtration barrier. The glomerulus is a component of the nephron, responsible for filtering blood and producing urine. The filtration process involves the filtration barrier consisting of the glomerular basement membrane (GBM), podocytes, and the endothelial cells.

**Why the Correct Answer is Right:** The correct answer, A, focuses on the specific feature of glomerular haematuria: the presence of red blood cells in the urine. This indicates an abnormal filtration of RBCs, which can be due to several factors affecting the glomerular filtration barrier.

**Why Each Wrong Option is Incorrect:**

B. Increased filtration rate (C) is not directly related to glomerular haematuria. Although increased filtration rate might be present in some cases, the primary focus should be on the presence of RBCs in the urine, represented by option A.

C. Proteinuria (option C) is a different feature of renal damage, characterized by the presence of protein in the urine. Proteinuria is not a feature of glomerular haematuria, emphasizing the need to differentiate between these two conditions.

D. Altered urinary sediment (option D) is related to the appearance of urinary sediment but does not specifically address the presence of red blood cells in the urine.

**Clinical Pearl:** Glomerular haematuria should be differentiated from macroscopic haematuria (visible red blood cells) and microscopic haematuria (invisible red blood cells under the microscope). Both conditions can indicate renal involvement but differ in the level of red blood cell concentration. Macroscopic haematuria is indicative of significant renal damage, while microscopic haematuria may be due to transient causes like urinary tract infections or medications.

**Correct Answer:** A. Presence of red blood cells in the urine (glomerular haematuria) is the main feature to focus on when assessing urinary sediment. This can help differentiate it from other renal conditions like macroscopic haematuria or microscopic haematuria. A comprehensive evaluation of the patient, including clinical history, physical examination, and laboratory tests, is crucial for determining the underlying cause and appropriate management.