Renal System 1. Polyurea - PowerPoint Presentation

Slide1

Renal System

1.

Polyurea

(Increase frequency of urine) >1500ml/day

Causes . Diabetes mellitus

.

Acrete

Nephritis / Nephrotic syndrome

. Post

Pitutary

tumour

2. Oliguria (Decrease frequency of urine) < 500 ml/day

3. Anuria (Absence of formation of urine)

Causes of oliguria & Anuria

. Pyrexia & Excessive sweating

. Vomiting, Loose motion, Dehydration

. Hypovolaemia

. Prostatic hypertrophy

.

Chronic Renal failure

.

CHF

.

Stricture in urinary bladder (Stone etc.)

4. Nocturia (Increase frequency of urine at Night)

. Diabetes Mellitus

. HTI

5. Haematuria:

True

Haematurea

False

Haematurea

Macroscopic

Haematures

Microscopic

Haematures

.

True

Haematurea

– Colour of urine is red and RBCs are present in urine (200 > 2RBC)

False

Haematurea

– Colour of

urine is red

but RBC are not present in urine.

Cause

– By eating Beat root

– Rifampicin

–

Pyridium

True Haematurea

Painful

Haematurea

Painless

Pre

Micturation

Haematurea

With

Micturation

Haematurea

(Mixed)

Post

Micturation

Causes –

Pre

Micturation

Haematurea

.

Urethal

Causes (Injury)

. BPH

–

With

Micturation

Haematurea

(Mixed)

.

Ureteric Causes (Stone)

. Renal Causes

. Stone

.

Polycustic

Kidney

. Glomerulonephritis

.

Malignaut

tumour in Kidney

. T.B. of Kidney

Post

Micturation

Haematurea

. Any cause in urinary bladder

. Cystitis

. Vesical Calculus

. CA of Urinary Bladder

Extra Renal Causes

. SABE

. Appendicitis

.

Salfringitis

. Diverticulitis

6. Retention of Urine: It should be differentiated from

Anurea

/ oliguria. In retention of urine kidney function is normal while oliguria & Anuria indicate towards disturbed function of the kidney.

Causes :

. Urethral obstruction

. Urethral Stricture

. Pin hole meatus (Esp. in children)

.

Phymosis

. Prostatic hypertrophy

. Spinal causes.

7. Incontinence of urine: Improper involuntary passage of urine resulting is wetting.

Causes:

. Common in old age (due to damage of brash cells)

. Common in

Multipase

(due to weakening of muscles)

. In

paraplagis

(lower body paralysis)

. Pressure on bladder

8. Pain in Renal angle or

lein

:

(Angle between 12

th

rib & Erector

spinaemus

).

Causes

. Inflammatory condition in Kidney (i.e., stone)

. It is colicky in nature

. It is in agony and in restless condition pain goes from loin to groin, scrotum, glans,

labias

.

Signs1. Oedems

:

.

Oedems

of Renal origin starts from face. (

Peri

or

bitaol

oedems

)

.

Oedems

of Cardiac origin starts from legs.

.

Oedems

of

Heptic

origin starts from abdomen.

2. Rashes on skin : seen in Uraemia

Breath smell : seen in Uraemia / Renal failure

3. Nails : Half

Half

nails seen in Renal failure.

Ben’s line (

Transverseriolgeson

nail – chronicity of dis.)

4. Ascites.

5. Signs of Hypertension (if Renal cause)

Inspection1. Oedems

/ Generalised

anasarce

in Acute Renal failure.

2. Skin: Rough, Dry, Dark brown with scratches & wrinkles in chronic

Renal failure.

3. Nails: White & Opaque nails in chronic Renal failure.

Palpation

Palpation of kidney by

Bimannual

method. Generally Kidney are not palpable.

palpable kidney indicates:

.

Hydronephrosis

(May be unilateral)

. Polycystic Kidney (Always Bilateral)

Persussion

. Fluid thrill

. Shifting dullness

. Pleural effusion may be in Nephrotic syndrome.

Anscultration

. Bruit (on

Renala

)

Indicates stenosis of

Renala

.

(If this sound is heard over the heart, it is called murmur.)

Investigation of Renal system1. Urine test

Physical examination

. Normal amount (It may vary from 700-2500ml)

. Specific gravity (1.003-1.030)

. Odour

Chemical Examination

. Protein

. Ketone bodies

. Bile salts

. Bile pigments.

Microscopic Examination

. RBS

. Pus Cells

. Cast (

Hyalina

Cast indicates

Glomerulonephrites

)

. Crystals

Urine Culture &

Sensitivity

2. R&T (Renal function test)

. Blood urea (Normal 20-40 mg / 100ml)

. Serum Creatinine (0.5 mg – 1.2 mg)

Radiological Investigation1. Plane X-ray abdomen for KUB (Kidney, Ureter, Bladder)

2. IVU (Intravenous Urography)

3. IVP Intravenous Pyelography)

for kidney function.

4. USG (Ultra Sonography)

5. C.T. Scan

6. Cystography

7.

Urethrography

8. MRI (

Magnatic

Resonant Imaging

)