Anamneza simptome

Question 1

motive prezentare la medic

Answer 1

colica renala

tulburari de mictiune

Question 2

hematurie microscopica
istoric familial de surditate
insuficenta renala

Answer 2

Sdr Alport

Question 3

hematurie microscopica

Answer 3

hematuria familiala benigna (fara surditate?)

Question 4

complex nefronoptizie

Answer 4

boala medulara chistica

Question 5

HTA proteinurie IR in sarcina

Answer 5

• prinele 2 trimestre - suferinta veche manifestata

- ultimul trimestru - suferinta primitiva

Question 6

alcool efect

Answer 6

• acut - inhibitie ADH => crestere diureza

- cronic - hipomagnezemie, hipokaloemie, dislipidemie => greu de controlat HTA

Question 7

reduc RFG prin dilatatie artera eferenta

hiperkaliemie (prin scadere aldosteron)

Answer 7

IEC

=inhibitori RAA

Question 8

constrictie arteriola aferenta

Answer 8

AINS

Question 9

substante de constract

Answer 9

scelroza sistemica nefrogena

Question 10

cisplatina (antineoplazic)

Answer 10

fibroza tubulo-interstitiala

Question 11

subst nefrotoxice

Answer 11

• metale grele
• tetraclorura de carbon (solvent organic)
• benzina => boala Goodpasture
• siliciu => poliangeita granulomatoasa
• Acid aristoholic => nefropatia endemic abalcanica, ierburi chinezesti

Question 12

glomerulonefrit cu formare de semiluni

Answer 12

rapid progresiv in saptamani

Question 13

capsula renala inextensibilia daca se intide stimuleaza R nociceptivi => cai vagale

Answer 13

tahicarhie
bradipnee
oprirea tranzitului intestinal, meteorism

Question 14

durere colica

Answer 14

• in flanc cu iradiere spre zona genitala
• evolutie stadiala
• data de obstructii ale cailor care destind rinichiul retograd

Question 15

clinic

Answer 15

pozitie antalgica - explute cauza peritoneala unde avem abdomen de lemn

• meteorisc
• manevra giordano pozitiva

Question 16

durere din nefralgie acuta

Answer 16

• iradirere anteriora, nu inferioara
• fara stadializarea durerii
• extensia capsulei dar nu de cauza obstructiva ci de cauza inflamatorie- edem

=se intalneste in

• pielonefrite acute
• abces renal
• flegmon perinefritic

-ruptura de chist cu infectare in polichistoza

=mecanism ischemic

• embolia arterei renale
• tromboza de vena renala stanga intre artera renala si aorta =SINDROMUL NUTCRACKER
• Loin pain hematuria syndrome (LPHS) causes severe, unexplained loin pain and blood in the urine (hematuria)

Question 17

sindron nutcraker

Answer 17

compresie vena renala intre aorta si artera renala stanga

=> pot aparea tromboze de la staza

Question 18

nefralgie cronica

Answer 18

calculi urinari imobili

Question 19

durerea ureterala

Answer 19

da spasm si creste presiunea in aval => confundare cu colica renala

Question 20

durerea vezicala

Answer 20

mai accentuata la sf mictiunii

• permanent cu exagerare diurna - cistita inclusiv intestitiala
• noturna - adenom de prostata
• permanent diurn si noctrun - tuberculoza, tumori vezicale
• legate de miscare - litiaza

Question 21

algurie

Answer 21

-durerea din timpul mictiunii

Question 22

polachiuria

Answer 22

frecventa urinara mare

• disurie, urina tulbure => infectei urinara joasa
• hematurie, jet intrerupt modifict de pozitie - litiaza vezicala
• polachiuria din a doua jumatate a noptii - hipertrofia benigna de prostata

Question 23

nocturia

Answer 23

mictiune care trezeste bolnavul din somn

Question 24

nicturie

Answer 24

se secreta mai multa urina noaptea mai mult de o treime

Question 25

vezica urinara hiperactiva

Answer 25

detrusor hiperactivat

Question 26

incontinenta urinara

Answer 26

-coborare col vezical => creste unghiul cu uretra=> mecanism ineficient =de stres - coborare planseu pelvin =prin imperiozitate - precedata de senzatie de senzatie urinara, vezica hiperactiva =incontinenta de prea-plin =neurologic - parkinson, neuropatia idabetica

Question 27

retentia de urina

Answer 27

obstructie subvezicala - adenom de prostata

Question 28

eliminar emai mult de 800ml din vezica

Answer 28

retentie urinara cronica acutizata

Question 29

Sdr Fowler

Answer 29

retentie acuta de urina la femei tinere

Question 30

retentie cornica de urina cauza obstructiva

Answer 30

- inittial e compensata de hipertrofia detrusorului - apoi apare volum post mictional, - glob vezical - hidronegroza cu cresterecreatinina

Question 31

opsiuria

Answer 31

=urinare tarzie sub 80 la suta din apa ingerata la 4 h - IC - ciroza hepatica - hiperestrogenism - probleme ADH - sindrom nefrotic (precipitare de proteina in glomerul?)

Question 32

poliurie hipotona

Answer 32

=data de cresterea RFG - hipertiroidie - febra - hipercatabolism =reabsorbtie scazuta apa - diabet insipid central - lipsa producere ADH - diabet insipid nefrogen - lipsa raspuns la ADH =aport crescut apa =poliurie postobstructiva

Question 33

poliurie osmotica

Answer 33

- DC - BCR - diuretice - hiperparatiroidism

Question 34

de ce apare nicturie

Answer 34

-pacienti cu BCR in clinstatism se resorb edemele si creste volumul plasmatic si RFG