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Nieren & Urinewegen Hoorcolleges
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Samenvatting van de hoorcolleges van het tweedejaars vak Nieren & Urinewegen in de bachelor Diergeneeskunde.
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BachelorJaar 2
Nieren en Urinewegen
HOORCOLLEGES
ARIANNE DE STERKE
, Arianne de Sterke – Nieren & Urinewegen
Inhoudsopgave
Thema A
Hoorcollege 1 – Inleiding NU ................................................................................................................... 2
Hoorcollege 2 – Micro- en macroscopische bouw NU ............................................................................ 3
Thema B
Hoorcollege 3 – Nierfunctie .................................................................................................................. 11
Thema C
Hoorcollege 4 – Regulatie van waterbalans .......................................................................................... 20
Hoorcollege 5 – Polyurie/polydipsie ..................................................................................................... 27
Thema D
Hoorcollege 6 – Reactiepatronen: macroscopie en glomerulopathieën .............................................. 30
Hoorcollege 7 – Volumeregulatie en oedeemvorming ......................................................................... 43
Thema E
Hoorcollege 8 – Probleemgerichte aanpak dysurie .............................................................................. 51
Hoorcollege 9 – Mictiereflex & probleemgerichte aanpak incontinentie............................................. 53
Thema F
Hoorcollege 10 – Zuur-base homeostase .............................................................................................. 56
Thema G
Hoorcollege 11 – Kalium homeostase ................................................................................................... 63
Thema H
Hoorcollege 12 – Nierfalen vs. nierziekten ........................................................................................... 65
Hoorcollege 13 – Probleemgerichte aanpak nierfalen.......................................................................... 68
1
, Arianne de Sterke – Nieren & Urinewegen
Thema A: Micro- en macroscopische bouw NU
Hoorcollege 1 – Inleiding NU
Macroscopie, microscopie, röntgenfoto’s (contrast), echografie.
- Anatomie
o Glomeruli (klarend vermogen), tubuli (secretie/resorptie).
o Ureteren (2) van nieren naar blaas, urethra (1) van blaas naar buiten – transport
o Blaas – opslag
- Practica
o Consistentie, bereikbaarheid – lichamelijk onderzoek
o Urineonderzoek inclusief sediment – laboratoriumuitslagen
- Symptomen in combinatie met therapie
o Nieren – polyurie/polydipsie, oedemen.
o Afvoerende urinewegen – incontinentie (passief urineverlies),
dysurie (actief urineverlies).
o Afwijkend plasgedrag: Pu/Pd, pollakisurie, dysurie, strangurie.
- Plan van aanpak patiënt
o Diagnostiek vs. behandeling
o Op basis van de waarschijnlijkheidsdiagnose
o Kostenbaten analyse (geld, moeite, ongemak, relevantie voor diagnose/therapie/prognose,
individu/koppel/eigenaar etc.)
Globale DDx verminderde nierfunctie:
Chronische nierziekte indien het minstens 3
maanden bestaat.
2
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