شرح للـ insulin و شلون نحسب الـ dose

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#week4 Urosurgery

بسم الله ⚘️
ملاحظات الاستشارية :
What is the differential diagnosis of radio opaque shadow in loin area?
Stone , forign body , gall bladder stone , calcified lymph node ,fecolith

Pylonephritis cause tenderness when palpating the kidney angle

Struvite stone has other names , include :
1-Ammonium , megnesium , phosphat ( الاسم العلمي )

2-infectious stone
لان المريضة (غالبا بالfemale ) يكون عدها اكثر من attack of UTI
3-Triple phosphate

Stone can cause turbid urine appearance

Imaging:
In US we can see size and site of kidney , kidney number ,hydronephrosis , parynchymal thickness , stone , mass ,diltation of ureter

Ct is the golden standered imaging for stone
99% من الstone نشوفها بال CT عدى نوع نادر هو " triamterne stone "
هذا الدواء هو potassium sparing diuretic ويستعمل في علاج ال hypertension مع الthiazide
ولكن هو يعتبر nephrotoxin لا يسبب crystalluria and cast formation
وممكن يسبب stone ولكن نادرا

ESWL: extracorporeal shock wave lithotripsy ( مطلوب الاسم )
It is a procedure to break up stones inside the urinary tract, bile ducts or pancreatic duct with a series of shock waves generated by a machine called a lithotripter. The shock waves enter the body and are targeted using an X-ray

Used for stones that are too large to pass on their own (larger than 5 millimeters in diameter — about the size of a pencil eraser)

🔍Another source -> ESWL used for stones that are less than 2cm

الفرق بين ESWL & laser lithotripsy

ESWL as an outpatient procedure does not require analgesia or anesthesia; it remains the first line therapy for proximal ureteral stones while ureteroscopic laser lithotripsy as a surgical procedure requires general anesthesia, hospitalization and much more costs
Eswl is used for stone less than 2 cm
analysis found Laser Lithotripsy can treat larger stones (> 2 cm) with good stone-free and complication rates

هاي مو كلها ذكرها الدكتور
يعني اكو معلومات اني هسة بحثت عنهن وضفتهن
بس الدكتور ذاكر هاي المواضيع يعني بشكل عابر

وطبعا المعلومات هواية فماتوقع اكدر اكملهن كلهن هسة
راح استمر لحد الي اكدر عليه وبعدها اكمل الباقي بغير وقت .. ان شاء الله ما أتأخر

We cant use urine sample to know if the stone is upper or lower
Unless we take smple from the kidney

Renal Colicky pain caused by stone is either due to obstruction by the stone or movment of the stone

Anatomical sites where stone can get lodged: The ureteropelvic junction (UPJ), the ureteral crossing of the iliac vessels, and the ureterovesical junction (UVJ

Vesical stone :
Primary :formed in the bladder
Scendory : the stone formed at another location and then get to bladder

Primary occurs in children
Scendory occurs in adult due to obstruction of urethra [ cause urine to accumlate in the bladder]

Or due to prostate enlargment which also interfere with urine outflow

Symptoms
intermittent urination
Loin pain
Pain during urination.
Testical pain
Nocturia & frequent urination
Blood in urine
Difficult urination or interrupted urination