The document outlines the structure and functions of the kidney and urinary system. It describes the parts of the nephron including the glomerulus, proximal and distal tubules, and collecting ducts. It discusses renal functions such as water balance, acid-base balance, and waste excretion. It also covers renal function tests, urinalysis, acute and chronic renal failure, glomerular diseases including nephrotic syndrome and nephritic syndrome, and specific conditions like glomerulonephritis.

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