Introductory first lecture The assistant to chair of the general practice therapy with a course of family medicine Kurenkeeva A.K.

Changes The name «Urinogenital system» is renamed on «Urinary excretion system»; Questions of a part of normal and topographical anatomy (topography of the testicle covers, perirectal fat; operative accesses and operations on kidneys), andrology (spermatogenesis), geriatric urology (a syndrome sexual disfunctions) are transferred on module "Reproduction“ ; Reinforcement methods of urinary tract system visualisation (beam diagnostics + radial urology); Interpretation of questions: development of urinary tract system and development anomalies differencing depend on faculty (pediatric or medical); Management of oncological patients is transferred on an older years; The syndrome nephritic eclampsy is transferred on a 4-year where it is included as a complication of the acute glomerulonephritis disease;

Clinical skills: To selection of syndromes Communication (complaints, anamnesis); General examination (visual inspection, palpation, percussion, auscultation); To selection of syndromes Lab tests; Instrumental tests; To confirmation of syndromes

Syndromes: Urinary tract infection (obstructive and non-obstructive forms); Isolated urinary syndrome; Nephrotic and acute nephritic; Acute and chronic renal failure; renal arterial hipertensive and renal eclampsia.

Problem №1 Patient M., 36 yrs, two weeks ago had tonsillitis after that noted change of urine color to reddish, headache, edema of face and lower extremities, backache. By examination: pale skin, edema of legs. By auscultation: harsh breathe, no crepitation. Beat tones are subdued, rhythmic, HB=80/min. Arterial BP=160/100mmHg. Abdomen―painless, no spasm. Kidneys aren’t palpated.

Oedema of ankles

ASCITES

hemodialysis

Student has to know: Anatomy Topography of the UES Histology Microbiology Biochemistry Radial diagnostic Normal physioilogy Pathological physiology

Student has to know: Localization, topography, fixing apparatus, structure of the kidneys; Structure of the nephron; Filtration, reabsorbtion, secretion, excration; Primary, secondary urine chemical composition; Metabolism, pH, proteinuria; Investigation of the uroinfections; Kinds of the urography, pyolography, CT, US et al.

Kinds of estimated activity Written examination (by means of questionnaires); Practical examination (on a concrete example (work with the real patient) or for the decision of a situational problem); The general estimation (group activity = a group estimation); Self-estimation (possibility to make own representation about level of the readiness); Oral presentation (communicative skills); The report (ability to document profession of a physician).

Questions of the knowledge level (test): Renal and extra renal complaints of the patient with urinary tract pathology; Features of the anamnesis of patients with urinary tract pathology; Mechanisms of a renal hypertension and renal hypostases (edema) formation; Rules of arterial pressure measurement; Criterias of: dis-, poly-, oligo-, an-, ish-, strung-, nockt-, pollakiuria; Technique of the physical inspections of patients with urinary tract pathology; Indicators of the general urine analysis: protein-, hemat-, leicocyt-, cast-, bacteriuria; Tests: glomerular filtration rate, Zimnitsky, Nechiporenco; Data of biochemical analyses of blood and urine; Technique of the X-ray, ultrasonic investigations of the kidneys; Criteria of syndromes at diseases of urinary system: pain, urinary, disuric, nephrotic, nephritic, acute and chronic renal failure, a renal arterial hypertension, an urinary tract infection syndromes.

Card of the patient with urinary tract pathology Syndrome; Definition, process localisation, criteria; Etiology, pathogenesis, pathomorphology; Clinical displays; Diagnostics methods (laboratory with interpretation of microbiological and biochemical changes, instrumental tests); Features of display of the given syndrome at children The resume (outcome)