Urinary tract system
Semester 6th ()
Code MED_661
Hours Teaching 25 hours
Teachers
Description
- Anatomy - physiology of the urinary system
- Clinical syndromes of renal diseases
- Acid-base balance disorders
- Water and electrolytes disorders
- Glomerular diseases
- Acute kidney injury
- Chronic kidney disease
- Hypertension
- Diabetes and kidney
- Systemic diseases and kidney
- Renal replacement therapy
Scope
Teaching is performed through lectures in the auditorium, while for a few days the students visit in groups the nephrology clinic where interesting cases are presented and discussed.
Learning objectives:
Students are taught all aspects of clinical nephrology. Special attention is specifically given to certain topicsand with the successful completion of the course, the student will be able to describe the following
- Physiology of kidney function: glomerular filtration, urinary tubules functions, urine concentration and dilution mechanisms.
- Urinary tract anatomy (kidneys, ureters, bladder)
- Histology of renal tissue: glomerulus, urinary tubules, interstitial space.
- Basic principles of clearance of substances - glomerular filtration rate calculation
- General findings in urinalysis. Findings in urinary sediment
- Haematuria
- Albuminuria
- Nephrotic syndrome
- Nephritic syndrome
- Mixed syndromes
- Body Acid-base balance and mechanisms of its conservation (body normal pH, importance of pH changes, daily production of hydrogen ions from metabolism). Description of the regulatory systems that contribute to the maintenance of acid-base balance. (Extracellular space: bicarbonate system, proteins) (intracellular space: intracellular proteins, hemoglobin, phosphates).
- Recognition of the role of the kidneys in maintaining acid-base balance. (Urinary tubules: elimination of hydrogen ions, bicarbonate ions and reabsorption of bicarbonate, renewal system in the circulation).
- Recognition of the role of the lungs to maintain the acid-base balance. (Lungs: elimination of carbon dioxide (CO2) which is formed in the circulation as a result of the hydrogen ion binding of bicarbonate ions to maintain the pH constant).
- Definition of decompensated and non decompensated metabolic disorders (acidosis or alkalosis).
- Mechanisms of decompensation of acid-base balance disorders. (Metabolic disorders: decompensation of the respiratory system, eg, tachypnea in acidosis) (respiratory disorders: decompensation of kidney).
- Diagnosis and differential diagnosis of the causes of metabolic acidosis or alkalosis (blood gases, determination of anion gap).
- Treatment of the acid-base balance disorders.
- Mechanisms responsible for maintaining the balance of potassium, sodium, calcium, magnesium, phosphorus organism and factors affecting them (acid-base equilibrium, insulin, aldosterone, antidiuretic hormone, parathyroid hormone).
- Recognition of clinical signs related to potassium, sodium, calcium, magnesium and phosphorus disorders.
- Causes that are responsible for causing electrolyte imbalances and search for those causes by taking a detailed history.
- Treatment of patients with electrolyte imbalances, in particular those with hypo- or hyperkalemia, hypo- or hypernatremia and hypo- or hypercalcemia.
- Identification of the cause, the diagnostic approach and treatment of glomerular diseases constitute a major objective of the training program
- Clinical syndromes of glomerular diseases (nephritic - nephrotic - mixed)
- Idiopathic glomerulonephritides
- Secondary glomerulonephritides
- Definition of acute kidney injury (AKI)
- Pathogenesis, predisposing factors and incidence of acute kidney injury.
- Causes and differential diagnosis of the causes of acute kidney injury: Recognition of prerenal, intrinsic and postrenal causes of AKI from history taking, physical examination and laboratory and imaging evaluation (biochemical blood tests and urinalysis, urinary tract ultrasound, etc.).
- Complications of acute kidney injury
- Treatment of acute kidney injury: Basic principles of treatment of AKI due to prerenal, intrinsic and postrenal causes. Indications for renal replacement therapy.
- Staging - impact - etiology - clinical picture - treatment of Chronic Kidney Disease.
- Definitions and classification of Hypertension. Pathophysiology - clinical manifestations - patient investigation - treatment of hypertension (conservative - pharmaceutical). Secondary forms of hypertension.
- Dialysis methods (Hemodialysis)
- Peritoneal Dialysis
- Kidney Transplantation
Reading Material
Harrison's Nephrology and Acid-Base Disorders, 1st Edition, J. Larry Jameson, Joseph Loscalzo.