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A vese

2009.12.21

A vese

 

Alkalmanként az előző betegségek:

Nephritis – tonsillitis

Vese tbc –tüdő

 

Panasz: gyengeség

fejfájás – hypertonia

akut nephritis – korai jel

uraemia (kínzó)

hányás, nansea (uraemia, veseköves görcs)

hasmenés (uraemia)

fájdalom – vesekő – görcs húgyutak mellett

nemiszervek

comb

u.a.

vizelés – gyulladás

mennyiség

jelleg

 

Megtekintés: sápadt erek szűkülete – akut)

idült: anaemia

sárgás (napfénynek kitett hely

urokromogen (nem tudja kiválasztani

UH fény bőrben urokrom (sárgás)

oedema: több vesebaj

akut nephritis

LAZA KÖTŐSZÖVET (arc, szemhéj)

alig követi a nehézkedés törvényét

légzés: dyspnoe

Kressual – acidosis

tapintás: vese helyzete

ballotálás

normalisan nem tapintható

2 oldali nagy vese policystás

ütögetés: a vesék rázásra érzékenyek

 

Vérnyomás: féloldali, a ren. szűkület – RR

glomerulopathiák RR

terhesség

akut veseelégtelenség systolés és diastolés

 

INREFLEXEK kötelező (naponta 2x)

Fokozottá válik fenyegető agynyomás fokozódás

 

 

 

Szemfenék: vérnyomás értéktől függenek

retina eltérések és diabeteses nephropathia (diff. Dg.-jében különösen

fontos)

 

Vizelet vizsgálat: V: 1000-2000 ml

<500 oligaria

>3000 polyuria

<100 anuria

hólyag kapacitás 200-400 ml. Hólyagtól feszülés –ürülési inger

-reflex

-megszokás

 

ürítési zavar: dysuria

prostata

daganat

gyógyszer – MO. per os sympathykum (atropin,

chinidin)

hólyag eredetű anuria

fiz. Kivizsgálható

ürítési zavar – katéter

 

nycturia: reggel = vagy több card. decomp.

Anuria – okai: akut nephritis

terhességi vesebaj

chr. nephritis

shock

oliguria: azok a veseműködés zavarok, amelyek anuriát

okozhatnak

nephrosis

card. decomp.

exsoccosis

fokozott extrarenalis folyadékleadás

 

polyuria – okai: vesebetegség kompenzáló ?????

oedema

diureticum

D.M.

fokozott folyadék bevitel – alkohol

fiziológosan (extracellularis vízleadás

HIDEG)

neurotikus polydiptok ????

 


A veseszindromák és vesebetegségek diagnosztikája

 

GRF

Se kreatinin cc akkor, ha a GFR már 30 ml/perc alatt

Urea – nitrogen cc 15 mmol/l

azotaemia

a szérumban visszamaradt nitrogén tartalom

vegyületek cc-ja megnő

Uraemia klinikai tünetcsoport

akut

chr. idült vesebeteg III-IV. stádium

fejfájás, étvágy , émelygés, hányás

hasmenés fascicularis ?????

nephrosis proteinuria 3,59/24 óra

 

 

Belgyógyászati jellegű vesesyndroma

Akut v. gyorsan progrediáló veseelégtelenség

Akut nephritis

Nephrosis

Tünetmentes vizelet eltérések

Idült veseelégtelenség

Renalis tubulopatia – elektrolit zavar, osteodysphasia

HYPERTONIA

 

Belgyógyászati urológiai vesesyndroma:

Húgyúti fertőzés

Vesekő, elfolyás zavar, gócnephritis

 

 

 

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