edema

4-associated feature with ascites include distortion or aversion of umbilicus and abdominal striae ,diverication of recti and occasionally meralgia parsthetica and scrotal edema ,pleural effusion can be found in 10%of pt. usually on Rt side most are small and only detected on chest X-ray

Investigation:

1-Ultra sound is the best methods of confirming the ascites.
2-Radiographic; can show ascites but are insensitive and non-specific
3-Abdominal Paracentesis; Aspiration of fluid for

analysis.

General appearance and color may help to identify the causes like: cirrhosis and H.F; clear, or slight yellow
T.B-straw-color
Infection –cloudy
Malignant –bloody
Biliary communication –deep yellow bile staining
Lymphatic obstruction –milky –white
Two type of fluid in Aspiration
Exudate;
1-protein more than 30gm/l.
2-serum/ascitic proportion less than 1.5 .
3- cell more than 250/mm3.
4-causes infection, T.B, panceratitis, malignant, hypothyroidism.


Transudate; protein less than 30gm/l .2- serum/ascetic proportion more than 1.5 .3- cell less than 250/mm3.
4- Causes, liver cirrhosis, H.F, nephritic synod.
Treatment:
1-treat the underlying causes.
2-Na and water retention.
3-diuretic –especially spironolacton (lactones).

Manifestation of renal diseases

Manifestations include symptoms and signs

Anatomy

Physiology
Main points
PAIN ; types of pains encountered in human being.
Renal pain

Ureteric pain

Urinary bladder pain


A. Regarding urination

1. Amount of urine…

Normal
Abnormal-polyuria
-oliguria
- anuria
-nocturia
2- dysuria
3- frequency
4- hesitancy
5- urgency
6- precipitancy

Color of urine

-normal
-abnormal
1- dark yellow urine
2- darkening on standing - porphyria,methyldopa,alcaptonuria
3- red urine - hematuria,hemoglobinuria,myoglobinuria,dyes(beet root),drugs


Features related to urine voiding
1- enuresis
2- incontinence
3- retention
4- retention with over flow

General features related to renal disease

1- fever
2- vomiting
3- edema