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Course, academic year 2024/2025
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Nephrology, urology, rheumatology and geriatrics - CVSE4P0023
Title: Nefrologie, urologie, revmatologie a geriatrie (KPZM V)
Guaranteed by: Department of Internal Medicine 3FM CU and UHKV (12-2INK)
Faculty: Third Faculty of Medicine
Actual: from 2022
Semester: both
Points: 7
E-Credits: 7
Examination process:
Hours per week, examination: 20/116, C+Ex [HS]
Capacity: winter:unknown / unknown (unknown)
summer:unknown / unknown (unknown)
Min. number of students: unlimited
4EU+: no
Virtual mobility / capacity: no
Key competences:  
State of the course: taught
Language: Czech, English
Teaching methods: full-time
Level:  
Note: you can enroll for the course in winter and in summer semester
Guarantor: prof. MUDr. Ivan Rychlík, CSc.
Examination dates   Schedule   
Annotation -
Information about subject (by Department of radiodiagnostics) is in application Vyuka (http://vyuka.lf3.cuni.cz).
Last update: Kubánek Ondřej (30.09.2013)
Aim of the course -

 

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.

Last update: Rychlík Ivan, prof. MUDr., CSc. (20.11.2019)
Course completion requirements -

The subject NURG is obligatory.

Conditions to get the credit:

1) 80% attendance at controlled parts of the teaching, i.e. practice, seminars.

2) Successful completion of a credit test.

Topics to be tested: in agreement with topics of seminars and lectures in following parts of the subject NURG: Syllabus of rheumatology, Syllabus of urology, Syllabus of geriatrics, Syllabus of nephrology - only pre-clinical subjects (pathology, pathophysiology, pharmacology).

Test will be managed as a multiple choice test, 90 questions/90 minutes, 4 answers, 0-4 correct. Minimal required success: >75% in total and >70% in each subtopics. 

The assessment period for resits are 3, ie. the student can take the exam up to 4 times and if he or she fails, no credits will be given. The student must take advantage of the assessment period, otherwise he or she loses this option and thus may not receive credits even though he did not take the exam 4 times.

 

According to 3LF UK, all exams are held in person. 

The condition for admission to the oral exam is the successful completion of a written test + presentation of attendance. Attendance records must be submitted no later than on the day of the oral examination to the IK secretariat (put in the mailbox in front of the secretariat, building N, 3p). The credit will be entered in the SIS on the day of the oral examination.

 

Test 

It is possible to pass the written test in the pre-term once, in case of failure it is possible to repeat the test only in the regular examination period. Successful completion of the written test is a condition for admission to the oral exam.

 

The oral exam 

Capacity is limited, pre-term only 12 - 18 students.

There are 3 resit dates, i.e. the student can take the test no more than 4 times and if he fails, he does not get credit. They must use the regular announced dates available in the SIS. In case of registration and failure to complete (without apology), this deadline expires.

Last update: Jajová Bekime, DiS. (29.09.2023)
Literature -

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

Dvořáček Jan : UROLOGIE I., II., III

Kawaciuk Ivan : UROLOGIE

Pavelka, Vencovský,Horák a spol., Revmatologie- 2.vydání 2018, Maxdorf, 2012, 2018 , ISBN 978-80-7345-583-5

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

 

Last update: Jajová Bekime, DiS. (29.09.2023)
Teaching methods -

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.

 

All lectures and seminars will be according to the schedule.

Students must be physically present at practical lessons and clinical training and their attendance will be always confirmed  by the assigned teacher. 

If the student cannot participate in clinical teaching for objective reasons (not able to come to the Czech Republic) must individually contact prof. Rychlík (intsec@fnkv.cz) for next instructions.

 

Last update: Jajová Bekime, DiS. (30.10.2023)
Requirements to the exam -

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.

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.

NOTICE! Since the academic year 2016/17, the subject ends by an oral examination of nephrology.

Topics to be tested: in agreement with topics of seminars and lectures of nephrology (see: Syllabus of nephrology)

Terms of the oral exams:

1/ during regular examination period

2/ for those who are interested (limited number of participants): during the week following the end of subject NURG

      

 

 

 

 

                     

 

 

 

  

 

 

Exam questions:

1st set of questions (clinical nephrology):

  1. nephrotic syndrome - definition, clinical symptoms, complications

  2. nephritic syndrome - definition, clinical symptoms

  3. nephrotic syndrome - definition, diseases that cause it (examples, characteristics)

  4. nephritic syndrome - definition, diseases that cause it (examples, characteristics)

  5. proteinuria – classification by intensity, prognostic importance, renal consequesnces

  6. hematuria – classification by type, diagnostic methods, examples of diseases

  7. proteinuria – individual types of proteinuria with examples of diseases

  8. evaluation of renal function – diagnostic methods

  9. edemas - differential diagnostics, characteristics of different causes of edema

  10. glomerulonephritis - classification, clinical symptoms, prognosis

  11. minimal change disease – clinical symptoms, diagnostic methods, treatment, prognosis

  12. acute glomerulonephritis – clinical symptoms, prognosis, principles of treatment

  13. prerenal, renal and postrenal disorders of kidney function - classification, examples of diseases

  14. rapidly progressive glomerulonephritis - classification, clinical symptoms, examination methods

  15. focal and segmental glomerulosclerosis- clinical symptoms, diagnostic methods, treatment, prognosis

  16. Goodpasture’s syndrome - classification, clinical symptoms, diagnostic methods, treatment, prognosis

  17. membranous nephropathy – clinical symptoms, diagnostic methods, treatment, prognosis

  18. ANCA-associated vasculitides - classification, clinical symptoms, diagnostic methods, treatment, prognosis

  19. gammopathy of renal significance – clinical symptoms, diagnostic methods, treatment, prognosis

  20. IgA nephropathy - epidemiology, clinical symptoms, diagnostic methods, treatment, prognosis

  21. diabetic kidney disease - epidemiology, mechanisms of kidney damage, characteristical clinical findings

  22. chronic glomerulonephritis - classification, clinical symptoms, diagnostic methods

  23. diabetic kidney disease – diagnostic methods, treatment, prognosis

  24. kidney damage in arterial hypertension – mechanisms of kidney damage, diagnostic methods, treatment, prognosis

  25. acute urinary infection - classification, clinical symptoms, diagnostic methods, treatment

  26. non-infectious tubulointerstitial kidney diseases- classification, clinical symptoms, diagnostic methods, treatment, prognosis

  27. thrombotic microangiopathy with renal involvement - classification, clinical symptoms, diagnostic methods, treatment, prognosis

  28. kidney damage in infectious diseases primary affecting other organs or systems

  29. stenosis of the renal arteries – clinical symptoms, diagnostic methods, treatment, prognosis

  30. hereditary kidney diseases – basic types of diseases, clinical symptoms, diagnostic methods, prognosis

2nd set of questions (RRT):

  1. renal transplantation – basic description and key principles

  2. vascular access for hemodialysis

  3. renal transplantation - methods, indication and contraindication

  4. conservative treatment of chronic kidney disease

  5. renal replacement therapy – how to choose the method

  6. diet and nutritional disorders in patients with chronic kidney disease

  7. hemodialysis - principle, description of the method

  8. cardiovascular complications of the chronic kidney disease

  9. hemodialysis - complications, impact on life of the patient

  10. pharmacotherapy in patients with the impairment of renal function – changes in pharmacokinetics and its consequences, examples of high risk drugs, consequences for the clinical practice

  11. peritoneal dialysis - principle, description of the method

  12. specifics of usage of a RTG contrast agents in a patient with impairment of renal function

  13. peritoneal dialysis - complications, impact on life of the patient

  14. antibiotic therapy in patient with an imparment of renal function

  15. acute kidney injury (AKI) - classification, examples of diseases, main principles of treatment

  16. chronic kidney disease - definition, staging

  17. acute kidney injury (AKI) – predisposing factors

  18. chronic kidney disease – clinical importance, prognosis, main principles of treatment

  19. acute kidney injury (AKI) – types of inducing insults, prevention

  20. uremic syndrome - definition, clinical characteristics

  21. acute kidney injury (AKI) – diagnostic methods, differential diagnostics

  22. renal anemia - patogenesis, clinical characteristics, main principles of treatment

  23. acute tubular necrosis - classification, examples of diseases, clinical symptoms, main principles of treatment

  24. metabolic bone diseases in chronic kidney disease - pathogenesis, clinical characteristics, main principles of treatment

  25. hemoelimination methods in acute kidney injury – indication, methods

  26. arterial hypertension in chronic kidney disease

  27. renal replacement therapy - indication, clinical importance

  28. hyperkalemia in chronic kidney disease – causes, clinical symptoms, main principles of treatment

  29. renal replacement therapy – classification of the methods and their differences

  30. acid-base balance disorders in chronic kidney disease - patogenesis, clinical characteristics, main principles of treatment

 

Choice of questions:

Each student will randomly choose a question number. He will get one question from the 1st set and one question from the 2nd set.

Last update: Jajová Bekime, DiS. (22.09.2023)
Syllabus -

I. Syllabus nephrology

 

  

1.       Introductory seminar (prof. Rychlik, dr. Havrda)

a.       organization information, credit conditions, overview of the syllabus

b.       basic classification of the kidney diseases (prerenal x renal x postrenal, vascular, glomerular, tubulointerstitial diseases, diseases of the urinary tract)

c.       review of the symptomatology of the kidney diseases (subjective complains such as pain, urinary symptoms, oligoanuria, polyuria, nycturia, hematuria, proteinuria, basic nephrologic syndromes – nephrotic x nephritic, edemas, hypertension, uremic syndrome)

d.       basic epidemiological data of patients with kindey diseases

e.       basis tests review (urinary sediment, urine culture, sodium, potassium, calcium, phosphates, urea, creatinine, Astrup, ultrasonography, X-ray methods, scintigraphy, imunology, paraprotein detection, renal biopsy)

f.        Trajectory of patients with CKD (higher risks of CKD-early diagnosis-slowing of progression-preparation for RRT / conservative care-basic RRT methods)

2.       Laboratory and other tests in nephrology (Dr. Habara, Dr. Žabka)

a.       Glomerular filtration tests – urea, creatinine, cystatin C, clearance, estimations, measurements with inulin, isotopes

b.       Differentiate between evaluation of stabilised kidney function and changing kidney function

c.       Proteinuria evaluation – quantitative proteinuria, PCR, ACR, proteinuria typisation,

d.       Hematuria evaluation – hematuria typisation,

 3.       Acute kidney injury (Dr. Grussmannová, Dr. Krátká)

a.       AKI definition, stages

b.       Predisposing states and factors of AKI. Hydration evaluation

c.       AKI caused by contrast agent, drug-associated AKI (ATN, ATIN)

d.       Hepatorenal syndrome

e.       Cardiorenal syndrome

f.        AKI prevention

g.       Tests used for differential diagnosis of the etiology, renal biopsy indications

h.       Treatment of the AKI, corticotherapy indications (ATIN)

i.         Elimination methods in AKI (HD, CRRT, PD) – indications, performing)

4.       Chronic kidney disease (Dr. Bandúr, Dr. Lažanská)

a.       CKD definition, stages

b.       Differentiation of active disease, tests, indication of renal biopsy in unclear kidney disease

c.       Uremic syndrome (clinical-laboratory presentation)

d.       Complications of the CKD and their treatment – anemia, acidosis, CKD-MBD, nutrition and diet, hypertension, cardiovascular complications, specifics of pharmacotherapy

 

  

 5.       Differential diagnostic seminar 1 – discussion of case studies (Dr. Sýkora, Dr. Knížek Bonatto)

a.       Renal function evaluation in stable and unstable conditions

b.       Differentiation of type of the kidney disease and differentiation between acute and chronic disease according to clinical, laboratory and other tests

c.       Approach to the patient with AKI

d.       Approach to the patient with CKD

 6.       Kidney and the vascular diseases (Dr. Krátká, Dr. Havrda)

a.       Malignant hypertension, vascular nephrosclerosis, ischemic disease of the kidney

b.       Renovascular hypertension, secondary renal hypertension

c.       Vasculitis – overview, vasculitis of the large and medium-sized vessels affecting the kidney

d.       Thrombotic microangiopathy

 7.       Rapidly progressive glomerulonephritis (prof. Rychlik, Dr. Havrda)

a.       Symptomatology of the RPGN, overview

b.       Goodpasteur syndrome, anti-GBM nephritis

c.       ANCA-associated vasculitis

d.       Lupus nephritis

e.       RPGN as presenation of the HSP, IgAN

f.        Renal biopsy – indication, contraindication, performing, complications

 8.       Chronic glomerular diseases (Dr. Žabka, Dr. Havrda)

a.       GN classification according to morphology (classical) and pathophysiology (new)

b.       Idiopathic nephrotic syndrome (MCD, FSGS, MGN)

c.       IgAN, HSP

9.        Chronic glomerular diseases II. (Dr. Havrda, Dr. Žabka)

a.       Membranoproliferative GN – morphology, clinic, basic differential diagnosis

b.       Diabetic kidney disease

c.       Lupus nephritis

 10.       Infections and the kidneys (Dr. Knížek-Bonatto, Dr. Sýkora)

a.       Bacterial infections of the kidneys and urinary tract

b.       Acute postinfectious GN

c.       Parainfectious GN

d.       GN in viral infections

 

   

11.   Clinical-pathological seminar (Doc. Honsová)

a.       Acute, rapidly progressive and chronic kidney diseases focused on vascular diseases, RPGN and chronic glomerular diseases (seminars 6-9)

 12.   Tubulointerstitial kidney diseases (Dr. Lažanská, Dr. Bachroňová)

a.       Acute tubular necrosis, acute tubulointerstitial nephritis

b.       Damage of the kidney in myoglobinuria and hemoglobinuria, crystals induced kidney damage

c.       Chronic tubulointerstitial nephritis, drug associated kidney damage, chronic pyelonephritis

d.       Monoclonal gammopathy with renal significance (MGRS)

e.       Polycystic kidney disease

13.   Renal replacement therapy (Dr. Tetour, Dr. Szonowská, Dr. Bandúr)

a.       Basic classification of the RRT, indications

b.       Conservative treatment of the severe CKD, palliative nephrology

c.       Basic classification of dialysis treatment, basic physical principles of dialysis

d.       Hemodialysis – technology, vascular access, dry weight, ultrafiltration, HD prescription, complications, basic diet

14.   Other treatment options in nephrology (Dr. Szonowska, Dr. Lažanská, Dr. Tetour)

a.       Peritoneal dialysis

b.       Continual methods of RRT

c.       Home HD

d.       Plasmapheresis, hemoperfusion

e.       Kidney transplantation

15.   Differential diagnostic seminar 3, final – discussion of case studies (Dr. Havrda, prof. Rychlík)

a.       Tubulointerstitial kidney diseases, monoclonal gammopathies

b.       CKD patient care, arrangement of nephrology treatment, RRT indications

c.       HD, PD, Tx complications, acute states

d.       Test and exam preparations (structure, questions, demands, conditions for the credit and exam)

 

 

 

B/ Seminars organized by preclinical departments

  1. Pathophysiology of the kidney I

  2. Pathophysiology of the kidney II

  3. Pharmacology of the kidney and urinary tract I

  4. Pharmacology of the kidney and urinary tract II

 

Lectures:

 

 

1/Basic principles of examination of a patient with kidney disease

 

2/Glomerulonephritis

 

3/Tubulointresticial nephritis

 

4/ RRT (renal replacement therapy)

 

5/ AKI (acute kidney injury)

 

6/Possibilities of affecting the progression of nephropathy

 

 

 

II. 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

 

III/Syllabus of rheumatology - modul NURG

Seminars:

A/ organized by Internal Medicine Department 

1.       Basic overview of rheumatology

a.       Overview  of  rheumatic diseases (RD)

b.      Symptoms of rheumatic diseases  ( pain, arthritis, extra-articular features )

c.       Basic classification of RD

d.      Basic assessment of RD, basic interpretation of laboratory results ( blood biochemistry, immunology, radiography, ultrasound, densitometry)

 

2.       Rheumatoid arthritis

a.       Definition and clinical manifestations

b.      Diagnosis and diferential diagnosis

c.       Treatment and management

 

3.      Seronegative Spondarthritis

a.      Definition , a new classification

b.      Ankylosing spondylitis - clinical manifestations, diagnosis and diferential

          diagnosis, treatment and management

 

d.      Psoriatic arthritis -  clinical manifestations, diagnosis and diferential diagnosis,

treatment and management

 

4.       Gout

a.       Definition and clinical manifestations,

b.      Diagnosis and diferential diagnosis

c.       Treatment and management

 

B/ Seminars organized by other departments

1.       Pharmacotheraphy of rheumatic diseases

2.       Physical and rehabilitation treatment of rheumatic diseases

3.       Radiographic examination and imaging procedures in rheumatic diseases

4.       Metabolic diseases of bone (osteoporosis, osteomalacia)

 

Practise:

1.       Clinical rheumatology (1 st Department of Medicine) – examination of the joints and spine

Osteoarthritis, clinical manifestationes, examination of the patient

2.        Pathology:  Ligh microscopy of rheumatic diseases

3.       Pathophysiology:  Pathophysiology of calcium

 

Lectures:

1.       Connective tissue diseases I.

Systemic lupus erythematosus (SLE)

2.       Connective tissue diseases II.

Systemic sclerosis, Polymyositis and Dermatomyositis, Sjogren´s  syndroma

 

 

 

IV. 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

 

Last update: Jajová Bekime, DiS. (16.10.2023)
Learning resources
Recommendations for the evaluation of biochemichal parameters in nephrology (Dr. Granátová):
 
  1. What kidney function has my patient in a daily praxis?

  • Usual patient: s-creatinine (+ eGFR - estimated glomerular filtration (MDRD, event. CKD-EPI)
  • Muscle atrophy (dystrophy, malnutrition, immobilization, elderly) / big amount of muscles: s- cystatin C (+ estimated GFR based on cystatin  C)
  • Pregnant woman: s-cystatin C
  • Extremely obese: s-cystatin C

           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


  • Drug administration: s-cystatin C (+ estimated GFR based on cystatin  C)
  • Children: s-cystatin C  (small, thin, slight, low amount of muscles)

              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)


  1. Kidney deterioration suspected:

     s-creatinine (+ eGFR (MDRD, event. CKD-EPI, s-urea,

     albumin in urine,ACR (especially in diabetic patiens, hypertension)


  1. Worsening kidney function, acute kidney injury (AKI) suspected:


    • In outpatient department: trend in s-creatinine for 3- 4 days

                                                  (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.)


    • In hospital: s-cystatin C (event. NGAL)


  1. Type of proteinuria (PU):


    • Children:glomerular selective: minimal change disease (MCD)

                             glomerular nonselective: focal segmental glomerulosclerosis (FSGS),

                                                                        postinfectional glomerulonefritis (GN), other GN


  • Adults:   glomerular selective: minimal change disease (MCD)

                           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
Last update: Rychlík Ivan, prof. MUDr., CSc. (20.11.2019)
Entry requirements -

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.

Condition for the attendence of the subject is a completed exam from general foundations of pathology and pathophysiology.

 

 

 

Last update: Havrda Martin, MUDr. (29.09.2016)
 
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