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Surgery 2 - Third Year BHMS

Contents

Surgery 2 - Third Year BHMS

Contents

CoursesBHMSSurgery 2 - Third Year BHMSPOLYCYSTIC KIDNEY DISEASE

POLYCYSTIC KIDNEY DISEASE

Content

POLYCYSTIC KIDNEY DISEASE

Definition of polycystic kidney disease

  • Polycystic kidney disease (PKD) is a genetic disorder characterized by the growth of numerous cysts on the kidneys.

Types of polycystic kidney disease

  • Autosomal dominant polycystic kidney disease (ADPKD)
  • Autosomal recessive polycystic kidney disease (ARPKD)
  • Cystic medial degeneration
  • Medullary sponge kidney
  • Nephronophthisis

Pathophysiology of cyst formation

  • Cysts form due to the mutation of the PKD1 or PKD2 gene
  • Cysts grow and expand due to the accumulation of fluid within them
  • Cysts can cause damage to the surrounding renal tissue and lead to kidney failure

Clinical features

  • Haematuria (blood in the urine)
  • Hypertension (high blood pressure)
  • Flank pain
  • Abdominal pain
  • Nausea and vomiting
  • Fatigue
  • Weight loss

Diagnostic modalities

  • Ultrasound
  • Computed tomography (CT) scan
  • Magnetic resonance imaging (MRI)
  • Renal function tests

Complications

  • Kidney failure
  • Seizures
  • Hemorrhage
  • Aneurysm
  • Intracranial hemorrhage

Management of polycystic kidney disease

  • Regular monitoring of kidney function and blood pressure
  • Blood pressure control
  • Pain management
  • Management of complications
  • Dialysis or kidney transplantation in advanced cases

Investigations

  • Urinalysis
  • Blood tests for electrolytes and kidney function
  • Imaging studies such as ultrasound, CT, and MRI
  • Genetic testing for PKD1 and PKD2 gene mutations

Treatment

  • Blood pressure control
  • Pain management
  • Management of complications
  • Dialysis or kidney transplantation in advanced cases

Homoeopathic therapeutic medicines

  • Arnica montana for pain and inflammation
  • Aconitum napellus for anxiety and stress
  • Nux vomica for nausea and vomiting
  • Belladonna for fever and inflammation
  • Calcarea carbonica for kidney function and mineral balance

Surgical management

  • Nephrectomy (removal of the affected kidney)
  • Heminephrectomy (removal of half of the affected kidney)
  • Cyst drainage or aspiration
  • Embolization of bleeding cysts

Complications of surgery

  • Bleeding
  • Infection
  • Renal function impairment
  • Adverse reaction to anesthesia

Postoperative care

  • Monitoring of vital signs
  • Pain management
  • Monitoring of kidney function and blood pressure
  • Antibiotics to prevent infection

Follow-up

  • Regular monitoring of kidney function and blood pressure
  • Adjusting treatment as necessary
  • Monitoring for complications and managing them promptly