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Last update: prof. MUDr. Jiří Horák, CSc. (03.12.2012)
The aim of the subject NURG (nephrology, urology, rheumatology and geriatrics) is to teach students the approach to patients suffering from these illnesses and conditions, to take properly the patient´s history, to master relevant physical examination, to devise a plan of auxilliary diagnostic procedures and to evaluate corrrectly the acquired information by fomulating a working diagnosis. Finally, according to the circumstances, to recommend changes in the lifestyle, appropriate diet and both pharmacologic and non-pharmacologic therapy. The subject NURG lasts for five weeks. In the first two weeks, nephrology is taught followed by one week each of urology, rheumatology and geriatrics. The study is integrated, i.e. it starts with relevant pathophysiology and pathology followed by clinical presentation, diagnostics, treatment and prevention. Social aspects are dealt with esp. in geriatrics. |
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Last update: Bekime Jajová, DiS. (27.09.2021)
Studijní rok 2012-2013 Semestr:Zimní ze dne 05.09.12
KURZ: 3/NURG/I.interní klinika souhrnná sestava den:pondělí/10.12.12 8:00 9:30 A 4/1,2,11,12, 3/NURG/nefrologie seminář 221 seminární m. vyučuje: Ústav patologické fyziologie Dr. Bernášková: Patofyziologie ledvin I (česky)
9:45 11:15 A 4/1,2,11,12, 3/NURG/nefrologie seminář 221 seminární m. vyučuje: 1.interní klinika Dr. Havrda: Syndromologie renálních chorob (česky)
11:30 13:00 A 4/1,2,11,12, 3/NURG/nefrologie seminář 221 seminární m. vyučuje: Ústav patologie Doc. Vernerová: Patologie ledvin (česky) den:úterý /11.12.12 8:00 9:30 A 4/1,2,11,12, 3/NURG/nefrologie seminář 2 Burianova posl. vyučuje: Ústav patologické fyziologie Dr. Bernášková: Patofyziologie ledvin II (česky)
9:45 11:15 A 4/1,2,11,12, 3/NURG/nefrologie seminář 2 Burianova posl. vyučuje: 1.interní klinika Dr. Havrda: Akutní poškození ledvin (včetně odlišení akutní/chronické, RIFLE atd - česky)
11:30 13:00 A 4/1,2,11,12, 3/NURG/nefrologie seminář 2 Burianova posl. vyučuje: Ústav patologie Dr. Eis: Patologie ledvin a vývodných cest močových (česky) den:středa /12.12.12 8:00 9:30 A 4/1,2,11,12, 3/NURG/nefrologie praktika 425 učeb. biologie vyučuje: Ústav patologie Doc. Vernerová: Mikroskopování (česky)
9:45 11:15 A 4/1,2,11,12, 3/NURG/nefrologie praktika 824 učeb.1.interny vyučuje: 1.interní klinika 11:30 13:00 A 4/1,2,11,12, 3/NURG/nefrologie praktika 824 učeb.1.interny vyučuje: 1.interní klinika Dr. Havrda, Dr. Bandúr, Dr. Mokrejšová, Dr. Krátká, Dr. Křemenová, Bc. Fruhaufová - hemodialýza, peritoneální dialýza, klinická nefrologie - stáže (česky) den:pátek /14.12.12 8:00 9:30 A 4/1,2,11,12, 3/NURG/nefrologie seminář 327 Jelínkova pos. vyučuje: 1.interní klinika Dr. Bandúr: Chronické onemocnění ledvin I - anémie, kardiovaskulární komplikace, kardiorenální syndrom, farmakoterapie při CKD (toxicita léků, redukce dávek apod), prevence progrese (vztah AKI a CKD, Rtg kontrast atd), hodnocení renálního rizika (eGFR+PU) (česky)
9:45 11:15 A 4/1,2,11,12, 3/NURG/nefrologie seminář 327 Jelínkova pos. vyučuje: 1.interní klinika Dr. Havrda: Klasifikace chorob ledvin. Glomerulární choroby ledvin (česky)
11:30 13:00 A 4/1,2,11,12, 3/NURG/nefrologie seminář 327 Jelínkova pos. vyučuje: 1.interní klinika Dr. Havrda: Tubulointersticiální, vaskulární, hereditární onemocnění ledvin (česky) |
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Last update: Bekime Jajová, DiS. (31.05.2021)
The subject NURG is obligatory. The credit is granted on the ground of at least 80% attendance at controlled parts of the teaching, i.e. practicals. Not more than one absence in one week is tolerated.
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Last update: prof. MUDr. Jiří Horák, CSc. (03.12.2012)
Robbins and Cotran - Pathologic Basis of Disease (8th edition)- Kumar, Abbas, Fausto, Aster Eds. Elsevier, Saunders ( 2010) (ISBN978-1-4160-3121-5) McCance, K. and S. Huether (2002). Pathophysiology - The Biologic Basis for Disease in Adults and Children. St. Louis, Missouri, Mosby, Inc.: 1170- 1229 RIEDER / WERNER / FREUDENBERG. Basiswissen Allgemeine und Spezielle Pathologie 1. Auflage 2009, 748 Seiten, 391 Abbildungen ISBN 9783540792130, Springer Verlag Stewens A., Lowe J, Scott I. Core Pathology - (3rd edition Elsevier), 2009, ISBN 978-0-7234-3444-3 Guyton, A. C. Textbook of Medical Physiology. Saunders (2006). Smith and Tanagho's General Urology, Eighteenth Edition, Lange, 2012 Guyton AC and Hall JE Textbook of Medical Physiology, 11th ed. 2006. pp. 1 - 42 Paulev-Zubieta: New Human Physiology Textbook in Medical Physiology and Pathophysiology: Essentials and Clinical Problems http://www.zuniv.net/physiology/book/index.htm http://www.americangeriatrics.org/files/documents/health_care_pros/JAGS.Falls.Guidelines.pdf http://www.americangeriatrics.org/files/documents/beers/2012BeersCriteria_JAGS.pdf Reide, Schaefer: Pathologie, Georg Thieme Verlag 2005 Underwood et al., General and Systemic Pathology, Elsevier 2009 H. P. Rang, et al Pharmacology 7th ed. - Churchill Livingstone 2011 B. G. Katzung Basic & clinical pharmacology - - 11th ed. - Lange Medi. Books - McGraw-Hill 2009 M. J. Neal Medical Pharmacology at a Glance -. 6th ed. Wiley-Blackwell, 2009 British National Formulary No. 62 [nebo vyšší] - BMJ Books, September 2011 [nebo novější] Howland RD, Mycek MJ, Pharmacology (Lippincott's Illustrated Reviews Series). 4th ed. Lippincott‘s Illustrated Reviews 2008 Dale NN, Haylett DG. Pharmacology Condensed 2nd ed., Churchill Livingstone, 2009 Forbes CH.D.,Jackson W.F. Colour atlas and text of Clinical Medicine, Mosby-Wolfe., 2nd ed. Joints and Bones, p.121-161 |
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Last update: Bekime Jajová, DiS. (05.10.2020)
The subject NURG is taught by means of seminars, practicals and lectures. Teaching is integrated, i.e. it comprises pathophysiological mechanisms of the disease, pathological findings, physical examination, auxilliary diagnostic methods and both pharmacologic and non-pharmacologic treatment. |
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Last update: prof. MUDr. Jiří Horák, CSc. (03.12.2012)
Knowledge of anatomy, physiology, pathophysiology and pathology of the kidney, the urinary tract and locomotion apparatus including connective tissue. Basic diseases in nephrology, urology and rheumatology, their pathogenesis, clinical presentation, diagnostics and management. The approach to the elderly patients, specifics of diseases in the elderly, changes in clinical presentation, changes of drug pharmacokinetics in the old age, ethical and social aspects of caring for the elderly. The subjects ends by a written examination in the form of multiple choice question test (120 questions, four possibilities, just one is correct). A minimum of 65% of correct answers is required to pass the test. A precondition for the student to be allowed to sit for the examination is successful passing the exam General Foundations of Pathology and Pathophysiology in the third year. |
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Last update: Bekime Jajová, DiS. (27.09.2021)
Syllabus nephrology Seminars Pathophysiology of the kidney I Syndromology pf renal diseases Renal pathology Classification of renal diseases. Glomerular diseases Tubulointerstitial, vascular and hereditary diseases of the kidney Chronic renal diseases I - classification, osteopathy, acid-base balance, diet, the uremic syndrome Pharmacology of the kidney and urinary tract I Treatment in nephrology - immune suppression, plasmapheresis, nephroprotection Diabetes, hypertension and the kidney Pharmacology of the kidney and urinary tract II Evaluation of glomerular filtration, evaluation of proteinuria, types of proteinuria Indications for renal replacement therapy. Peritoneal dialysis. Transplantation of the kidney Renal replacement therapy - acute and chronic hemodialysis, continual methods (including vascular access) Chronic renal diseases II - anemia, cardiovascular complications, cardiorenal syndrome, pharmacotherapy in CKD (drug toxicity, dose reduction etc.), prevention of the progression, evaluation of renal risk (eGFR+PU) Pathophysiology of the kidney II Acute renal injury (including difference acute/chronic, RIFLE etc.) Pathology of the kidney and urinary tract
Lectures Primary glomerular diseases Secondary glomerular diseases Renal failure Renal pathophysiology Patophysiology of body fluids
Practicals: Microscopy Hemodialysis, peritoneal dialysis, clinical nephrology, renal sonography Radiological methods in examination of the kidney and urinary tract
Syllabus urology Examination methods in urology Imaging procedures in urology Clinical urology Non-neoplastic diseases of the urinary bladder and urethra Tumours of the urinary bladder Endoscopic diagnostics Benign prostatic hyperplasia, prostatitis Tumours of the prostate Incontinency Diseases of external genitals TBC in urology/ non-neoplastic diseases of the kidney
Syllabus rheumatology Classification of rheumatic diseases Examination methods in rheumatology Rheumatoid arthritis Spondarthritides Diffuse connective tissue diseases Gout Osteoarthritis Extraarticular rheumatism Rheumatic polymyalgy Imaging procedures in rheumatology Pharmacotherapy and physical and rehabilitation treatment in rheumatology Pathophysiology of calcium Metabolic bone diseases Pathology and microscopy in basic rheumatic diseases
Syllabus geriatrics Ageing and old age, theory of ageing, general characteristics Old age and stress, diseases in the elderly Physiological changes during ageing, changes in structure and function of organs Specificities of clinical symptomatology in the elderly; functional geriatric assessment Geriatric syndromes: Instability, vertigo and falls in the elderly Geriatric syndromes: Impairment of cognitive functions. Caring family in the Czech Republic Pharmacotherapy in the elderly History in a geriatric patient; diagnostics of pain in patients with advanced dementia Functional geriatric assessment. Active geriatric aftercare. Functional evaluation and rehabilitation Concept of geriatric care Ethical aspects in geriatrics. Life quality. Personal distinction Unappropriate pharmacotherapy in the elderly Case report seminar: Transient cognitive impairment during acute conditions in the elderly |
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Last update: prof. MUDr. Jiří Horák, CSc. (03.12.2012)
Recommendations for the evaluation of biochemichal parameters in nephrology (Dr. Granátová):
Remember: - to know thyroid function (TSH) - if uncompensated hyperfunction - falsely worse eGFR (and falsely better if uncompensated hypofunction) - in corticoid therapy falsely worse eGFR based on cystatin C (dependence on the corticoid dose) - eGFR based on s-creatinine is more appropriate
s-creatinine (+ estimated GFR based on Schwartz formula, MDRD/CKD-EPI not recommended), estimation for a daily praxis: maximal s-creatinine = body height (cm) x 0,54 the upper normal value of s-creatinine that fits to still undecreased GFR 1,5 ml/s)
s-creatinine (+ eGFR (MDRD, event. CKD-EPI, s-urea, albumin in urine,ACR (especially in diabetic patiens, hypertension)
(event. s-cystatin C, see above) If the rising trend continues, then admission to hospital Remember: - Biological + analytical variability in creatinine concentration day to day about 15% - Changes in s-creatinine are delayed in 24 - 48 hours after the cause (hypoxia, hypoperfusion, toxins etc.)
glomerular nonselective: focal segmental glomerulosclerosis (FSGS), postinfectional glomerulonefritis (GN), other GN
glomerular nonselective: idiopatic membranous glomerulopathy (IMG), focal segmental glomerulosclerosis (FSGS), diabetic nefropathy, monoclonal protein("paraprotein") - to perform serum electrophoresis (event.+ immunofixative electrophoresis if paraprotein is present, serum free light chains (FLC); if systemic amyloidosis (AL) is suspected, these tests are necesasary in serum + in urine glomerulo-tubular nonselective: advanced disease |
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Last update: prof. MUDr. Jiří Horák, CSc. (03.12.2012)
Student entering the subject NURG must have working knowledge not only of anatomy and physiology of the kidney, the whole urogenital system and the mobility apparatus but also of general pathology, pathophysiology, pharmacology, and intermediary metabolism. Further, he must understand principles of physician´s attitude to the patient including principles of medical ethics and be able to take patients´history and to perform physical examination. |
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Last update: Bekime Jajová, DiS. (31.05.2021)
The subject NURG is obligatory. The credit is granted on the ground of at least 80% attendance at controlled parts of the teaching, i.e. practicals. Not more than one absence in one week is tolerated.
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