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ILMU PENYAKIT DALAM I GANGGUAN DIURESIS, ELEKTROLIT, ASAM & BASA Dr.H. SYAIFUL AZMI, SpPD KGH

ILMU PENYAKIT DALAM I GANGGUAN DIURESIS, ELEKTROLIT, ASAM & BASA Dr.H. SYAIFUL AZMI, SpPD KGH. SUB BAG. GINJAL HIPERTENSI BAGIAN PENYAKIT DALAM FAKULTAS KEDOKTERAN UNAND RS.DR.M. DJAMIL PADANG. GANGGUAN MIKSI. ANATOMI GINJAL PROSES PEMBENTUKAN URINE 1. PROSES ULTRA FILTRASI

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ILMU PENYAKIT DALAM I GANGGUAN DIURESIS, ELEKTROLIT, ASAM & BASA Dr.H. SYAIFUL AZMI, SpPD KGH

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  1. ILMU PENYAKIT DALAM IGANGGUAN DIURESIS,ELEKTROLIT, ASAM & BASADr.H. SYAIFUL AZMI, SpPD KGH SUB BAG. GINJAL HIPERTENSI BAGIAN PENYAKIT DALAM FAKULTAS KEDOKTERAN UNAND RS.DR.M. DJAMIL PADANG

  2. GANGGUAN MIKSI • ANATOMI GINJAL • PROSES PEMBENTUKAN URINE 1. PROSES ULTRA FILTRASI - Terjadi dlm Kapsula Bowman - Dilalui : - air - elektrolit - bahan organik dg BM < - Tidak dilalui : - Sel darah - Protein - Jumlah 180 L/hr  urine 2 L/hr

  3. 2. PROSES REABSORBSI - Terjadi di tubulus - Yg diserap kembali - glukosa - air - as. amino - Na+ Cl- 3. PROSES EKSRESI SEPANJANG TUBOLI - H+, NH4+, K+

  4. PERJALANAN URINE DUCT COLL  CALIX MINOR  MAYOR  PELVIS RENALIS  URETER  VESICA URINARIA  URETHRA PROSES MIKSI SPP VESICA URINARIA  MEDULA SPINALIS PENUH M. DETRUSOR VESICAE KONTRAKSI MIKSI SPINTER URETRA RELAXASIMIKSI

  5. GANGGUAN MIKSI • DISURIA - NYERI WKT KENCING - LUKA SAL KENCING (URETRA) - BATU KANDUNG KENCING - INFEKSI – SISTITIS – PROSTATITIS - URETRITIS – VAGINITIS - NYERI PERMULAAN KENCING : URETRITIS - NYERI SEHABIS KENCING : SISTITIS • RETENSIO URINE - KENCING TAK BISA KELUAR, KANDUNG KENCING PENUH - PROSTAT : BPH, TUMOR - URETRA : BATU, STENOSIS, STRIKTUR

  6. 3. POLAKI SURIA - FREK KENCING SERING - SISTITIS - MASA DI KANDUNG KENCING, TUMOR , BATU 4. POLIURIA - URIN > 2 L / 24 JAM - DIABETES - PEMAKAIAN DIURETIK 5. INKONTINENSIA URINE - URIN KELUAR TERUS (RUSAK : SPINTER) - KELEMAHAN UMUM - KELEMAHAN SPINTER - INKONT PARADOKSAL - TERJADI STLH RETENSIO URINE LAMA

  7. 6. OLIGURIA - URIN < 500 cc / 24 jam - Non Renal : - dehidrasi - Syok - Renal : - Obstruksi - Peny. Ginjal Kronik 7. ANURIA - URIN < 50 cc / 24 jam - Non Renal: - Syok berat - Obstruksi total - Renal : - PGTA - Intok jengkol (GGA)

  8. 8. NOKTURIA - Frek. Kencing sering malam hari - Anak, DM / DI 9. HEMATURIA - ERITR DL URIN ( MIKRO / MAKROSKOPIS ) - Renal - GNC - Kista - PNC - Tumor - Batu - TBC - Ureter - Batu - Trauma - Keganasan - Buli-buli - Radang - Batu - Tumor - URETRA - RADANG - BPH / TUMOR - LAIN-LAIN - Diatesis hemorrhagica - intok jengkol

  9. 10. PIURIA - LEKOSIT DL URIN ( > 5 / LPB) - INFEKSI - PNC - URETRITIS - SISTITIS - TUMOR - BATU 11. PIURIA KONTAMINATIF - Lekosit tidak berasal dari sal. Kencing - Sering pada wanita DD / PIURIA MURNI & KONTAMINATIF • Sampel Urine : SP UPT / MSU • Kutur Urin - Koloni > 100.000 koloni / cc urin  P. MURNI

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