1. kidney & urinary system

3. Structure of kidney & Urinary system

10. Urinalysis Physical & chemical properties - pH, Specific gravity (1.022), protein, sugar, etc. Urine sediments - Cell-RBC, WBC, Renal cells, etc. - Urine casts - Crystalline structure

11. Urin a lysis profiles Specific gravity 1.001 - 1.035 Osmolarity 500 - 800 mOsm / kg water pH 4.7 - 8.0 Volume 600 - 1500 ml / 24 hr RBC 0- 1,000,000 / hours WBC 0- 1,000,000 / hour Tubular cells 10,000 - 200,000 / hour Casts 0- 5,000 / 24 hours

12. Hyaline cast : clear, tubular protein Granular cast : high protein from plasma Waxy cast : degraded granular cast Red cell cas t : glomerular disease Fatty cast : tubular damage WBC cast : pyelonephritis Bacteriological examination Renal biopsy Radiologic examination Plain KUB Intravenous pyelography ( IVP ) Granular cast Waxy cast Red cell cast

15. Chronic renal failure Causes : glomerulonephritis, chronic pyelonephritis, nephrosclerosis, lupus erythematosus, diabetes, renal tuberculosis decreased renal function Effects : Uremia syndrome 1. General symptom : Lethargy, insomnia, etc. 2. CVS : hypertension, edema, sterile fibrinous pericarditis 3. GI : เบื่ออาหาร , อาเจียน - gastritis, colitis (NH 3 ) 4. CNS : Lethargy ( ซึม ), peripheral neuropathy 5. Anemi a : Specific for uremia 6. Infection : UTI, Sepsis 7. Metabolic acidosis : หายใจหอบ

16. Glomerular syndrome Nephrotic syndrome Nephritic syndrome Chronic renal failure Nephrotic syndrome Severe proteinuria > 0.15 gm / day upto 10 g / d Hypoproteinemia Generalized edema Hyperlipidemia > 250 mg % Nephritic syndrome Hematuria Oliguria Azotemia : high Creatinine + BUN Hypertension : obstruction of capillary