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SYNTHESIS OF SYMPTOMS OF UROGENITAL SYSTEM

BY

DR I O MBAH (MB;BS, FWACP)

Chief Consultant Physician / Nephrologist & Snr Lecturer BHUTH

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ANATOMY OF THE UG SYSTEM

  • KIDNEYS : 2 bean shaped organs on either side
  • Each has 1 million fxnal unit ( Nephrons)
  • They filter the blood, allowing nitrogenous waste but not cells and proteins
  • Glomerulus- the filtration chamber is sieve like

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  • The tubules reabsorbs the filtrate
  • The Collecting Duct concentrates the filtrate
  • The URETERS one on either side, allows urine into…
  • The BLADDER stores the urine
  • The URETHRA is the outlet to outside

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THE MALE UROGENITAL SYSTEM

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THE FEMALE UROGENITAL SYSTEM

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INJURY; Physical, Chemical, Infective (Biological)

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INJURY TO THE KIDNEY

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THE INJURY IS A SPECTRUM

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Post-mortem

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THE WORD RIFLE EXPLAINS IT

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RIFLE EXPLAINED

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PATHOPHYSIOLOGY

  • PRE-RENAL
  • RENAL
  • POST-RENAL
  • OTHER Disease entities like Hypertension, DM, Collagen vascular diseases, HIV etc
  • AUTOIMMUNITY (eg Good Pastures affecting the lungs but biting the kidneys

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PRE-RENAL

  • Reduced Fluid intake
  • Excessive fluid loss (Xssive sweating, vomiting, diarrhea, bleeding RTA or in pregnancy etc)
  • Post-op drains / fluid deficiency

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Physical trauma, direct or indirect

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RENAL (Intrinsic)

  • Glomerular damage (Ag-Ab complexes)
  • DM
  • HT
  • Cysts formation
  • Congenital
  • Bee sting
  • Cosmetics (soaps, cream, Hg etc )

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CHEMICAL

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MAINLY GLOMERULAR ASSAULT

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NEPHRITIC SYNDROME

  • Haematuria
  • Proteinuria
  • Body swelling
  • HBP
  • Nausea
  • Vomiting
  • Other symptoms of renal Failure

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Nephrotic Syndrome

  • Massive proteinuria
  • Nil or trace proteinuria
  • Hypoalbuminaemia
  • Facial oedema, bil leg swelling
  • Ascites
  • Normal BP
  • Hypercholesterolemia
  • Hypercoaculopathy

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POST-RENAL

  • OBSTRUCTIVE UROPATHY
  • Oliguria / Anuria
  • Urinary retention in Kidneys (hydronephrosis), or / and in bladder

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  • OBSTRUCTIVE NEPHROPATHY
  • Uraemic syndr (nausea, vomiting, peripheral fluid retention

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RENAL ARTERY STENOSIS

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NARROW Vs WIDE Vessels

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HYPERLIPIDAEMIA

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From what people eat

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Or from inhaling Hydrocarbons

Baby elephant

Siphoning fuel / petrol attendant

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CLINICAL PRESENTATION (What symptoms are expected in Urogenital Disease?)

  • DISCOLOURED URINE

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OLIGURIA? Meaning??

  • Urine can be scanty : If scanty what could the problem be?

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  • BRAISTORM…..

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POLYURIA? What’s this? And the reason??

  • Urine can be much more than expected. Why?

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  • Brainstorm

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NOCTURIA: Any significance??

  • What’s this?

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  • BRAISTORM

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FOAMING URINE: Any significance?

  • Foaming urine

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  • BRAINSTORM

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INCREASE FREQUENCY OF MICTURITION, DYSURIA

  • What’s the significance?

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  • BRAINSTORM

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�Evidence of Fluid Retention�

  • What’s the evidence?

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  • What will the patient complain of?

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  • And why?

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  • BRAINSTORM

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AND WHAT AGAIN?

  • BRAINSTORM

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SYMPTOMS OF RENAL FAILURE

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  • Uraemic Syndrome
  • What are they?
  • Why? BRAINSTORM

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LOIN PAIN.

  • What’s the genesis of such pain

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  • The nature of the pain; Does it matter?

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ANASARCA

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  • So the history will include, FHx, SHx the lifestyle, occupation and some disease states (DM, HT etc) as well as the clinical presentations and may be, complications

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  • ? Any QUESTIONS

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ASSIGNMENT

  • What is the relevance of AGE, FMHx, SHx / Occupation and GENDER in the AETIOLOGY of disease?

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IMELA, SANU, NAGODE, OSHE