Introduction of Genitourinary Sistem PDF

Introduction

1. URINARY SYSTEM
PJMK : TAUFIQ NUR BUDAYA, DR, SP.U
EMAIL : [email protected]
HP: [phone]
[phone]

3. SIGNS AND SYMPTOMS

4. DAFTAR PENYAKIT URINARY

6. MKK Urinari 2019

Interna
ISK dewasa (4a) – pyelonephritis (4a)
AKI (2) – Akut tubular nekrosis (2)
CKD (2)
Hipertensi

Pediatri
ISK anak (4a)
Glomerulonefritis (3a)
Sindroma nefrotik (2)

7. Urologi

BPH (2) – prostatitis (3a) Obstruksi uropati,

Batu saluran kemih (3a) – kolik renal (3a)

Pediatrik urologi :
Fimosis (4a)
Parafimosis (4a)
Polikistik kidney (2)
Hipospadia (2)
Epispadia (2)
Horseshoe kidney (1)

Emergency nontrauma
Retensi urine (striktur uretra) (2)
Akut skrotum (torsio testis (3b), orchoepididimitis (2))
Pripapismus (3b)
Hematuria
Kolik
Urosepsis

8. Emergency trauma
Rupture ginjal (3b)
Rupture uretra (3b)
Rupture kandung kemih (3b)

Kanker urogenital
Kanker ginjal (2)
Tumor wilms (2)
Kanker urotelial (2)
Seminoma (1)
Teratoma testis (1)
Carcinoma prostat (2)

9. REPRODUKSI PRIA (BLOK REPRODUKSI)
•DISFUNGSI EREKSI, GANGGUAN EJAKULASI (2)
•INFERTILITAS PRIA (3A)
•KELAINAN ISI SKROTUM

10. SKILL URINARI
•PEMERIKSAAN FISIK GINJAL DAN KANDUNG KEMIH
•PEMERIKSAAN GENETALIA EKSTERNA LAKI-LAKI, COLOK DUBUR DAN REFLEKS
BUBLOKAVERNOSUS
•KARTETERISASI URETRA, CLEAN INTERMITTEN CATHETERIZATION (CIC), PUNGSI
SUPRAPUBIK
•SIRKUMSISI
•FARMAKOLOGI URINARY
Metode
1.Modul skill dan jadwal sudah dibagikan pada awal mkk urinary berlangsung
2.Mahasiwa wajib membaca dan mempelajari modul tersebut sebelum
berlangsungnya skill
3.Untuk sementara skill mkk urinari dilakukan secara daring
4.Metode pembelajaran : kuliah daring dan video demo
5.Pada saat berlangsungnya skill urologi mahasiswa wajib menyalakan video
6.Evaluasi : Urologi untuk skill tidak ada evaluasi/penugasan (OSCE)

11. PEMBAGIAN KULIAH
•25 SLOT KULIAH
•ANATOMI 3 SLOT + 1 SLOT PRAKTIKUM HISTO + 2 SLOT PRAKTIKUM ANATOMI
•FAAL 2 SLOT
•PK 2 SLOT + 1 SLOT PRAKTIKUM
•MIKRO 1 SLOT
•RADIOLOGI 2 SLOT
•PA 2 SLOT
•IPD 2 SLOT
•PEDIATRI 1 SLOT
•FARMAKO 2 SLOT
•IKM KP 1 SLOT
•UROLOGI 6 SLOT
•2 SLOT PBL

12. PERATURAN UMUM PERKULIAHAN BLOK
URINARI
•SEMUA MAHASISWA HARUS SUDAH LOG IN SESUAI JADWAL YANG TELAH DITENTUKAN
•USER NAME MAHASISWA (NIM_NAMA LENGKAP)
•CONTOH : 0310710143_TAUFIQ NUR BUDAYA
•KETERLEMBATAN LOG IN MAKSIMAL 5 MENIT
•ABSENSI BERDASARKAN SCREEN SHOOT LAYAR ZOOM DI AWAL DAN DITENGAH LECTURE
•TIDAK ADA TOLERANSI ABSEN SELAMA KULIAH
•VIDEO HARUS DINYALAKAN SELAMA KULIAH

13. PERATURAN PBL BLOK URINARI
•SEMUA MAHASISWA HARUS SUDAH LOG IN SESUAI JADWAL YANG TELAH DITENTUKAN
•USER NAME MAHASISWA (NIM_NAMA LENGKAP)
•CONTOH : 0310710143_TAUFIQ NUR BUDAYA
•KETERLEMBATAN LOG IN MAKSIMAL 5 MENIT
•ABSENSI BERDASARKAN SCREEN SHOOT LAYAR ZOOM DI AWAL DAN DITENGAH PBL
•MAHASISWA HARUS MEMPELAJARI KASUSNYA SEBELUM JADWAL PBL
•DISKUSI AKAN DIEVALUASI DAN DINILAI
•WAJIB AKTIF DALAM DISKUSI
•WAJIB MENULIS LAPORAN DAN RESUME DISKUSI UNTUK DISERAHKAN KE TUTOR
•TIDAK ADA TOLERANSI ABSEN SELAMA PBL
•VIDEO HARUS DINYALAKAN SELAMA PBL

14. UJIAN
•4 UJIAN TOPIK, CBT, RECALL
•UT 1, ANATOMI, PK DAN FAAL
•UT 2, MIKRO, RADIOLOGI, PA
•UT 3, PEDIATRI, FARMAKO, IKM
•UT 4, UROLOGI, IPD
•UTS MENGIKUTI JADWAL PRODI, MATERI MULAI UT 1- UT 2, ANALITIK
•UAS MENGIKUTI JADWAL PRODI MATERI 30% UT 1-UT 2, 70% UT3-UT 4, ANALITIK

15. NILAI AKHIR

17. PENINGKATAN NILAI SETELAH SP/UK MAKSIMAL
3 DIGIT (NILAI E ?????? C), NILAI MAKSIMUM B+

18. ORGANS THAT INVOLVE IN URINARY

19. CLINICAL PROCESS
History taking
Physical examination
Laboratory-imaging-othe
rs examination
Histopathology Examination

20. •History taking
•Physical examination
•Laboratory/Imaging/others examination
•Exploratory or biopsy for histopathology examinationDiagnosis
•Conservative / Behaviour / watchful waiting
•Medicinal
•Dialysis (haemo/peritoneal)
•Surgical
•Radiation
Treatment
•Re-assesment
•Treatment
Follow up

21. HISTORY TAKING: CHIEF COMPLAINT
•PRESENTING THE SYMPTOM(S) FELT BY THE PATIENT AND NOT A DIAGNOSIS
•URINARY HISTORIES OR SYMPTOMS
Pain
Kidney or ureteral pain
Vesical pain
Prostatic pain
Testicular pain


Symptoms related to act of urination
(LUTS)
Irritative/storage symptoms
•Frequency
•Nocturia
•Dysuria
Obstructive /voiding symptoms
•Hesitancy
•Decrease force of urination
•Intermittency
Post micturition
•Post void dribbling
Incontinence
Enuresis
Change in appearance of urine:
Hematuria (bloody urine)
Pyuria
Cloudy urine
Orange brown:
•conjugated bilirubin, rhubab, concentrated normal
urine (very low fluid intake)

Symptoms sugestive of chronic renal
failure
Oliguria
Polyuria
Anorexia, vomiting, hiccup, insomnia
Itch, bruising, oedema

Urethral or vaginal discharge

22. REGIONS,
QUADRANTS,
AND SURFACE
PROJECTIONS

23. BIMANUAL KIDNEY PALPATION

24. CVA KNOCK PAIN

25. TRANSILUMINASI

26. BLADDER BIMANUAL PALPATION

27. DIGITAL RECTAL EXAMINATION

28. LABORATORY TEST:
URINALYSIS, BLOOD TEST, AND ECG

29. LABORATORY TEST
•BLOOD
•COMPLETE BLOOD COUNT
•RENAL FUNCTION TEST (UREUM, CREATININ SERUM, CYSTATIN C ??????
MORE SENSITIVE)
•TUMOUR MARKER : PSA, BETA HCG, AFP, LDH
•ELECTROLYTE : NA, K
•BLOOD GASS ANALYZE
•URINE
•URINALYSIS
•CREATININE CLEARENCE
•URINE CULTURE

30. IMAGING: ULTRASOUND

31. IMAGING:
KIDNEY URETER BLADDER
IMAGING:
INTRAVENOUS UROGRAPHY
(IVU)/IVP/EXCRETORY UROGRAPHY
IMAGING:
REFLUX STUDY

32. IMAGING:
MAGNETIC RESONANCE IMAGING (MRI)

33. UROFLOWMETRY
Male 70 years old with LUTS

34. URODYNAMIC

35. SCINTIGRAPHY BONE SCAN

36. RENAL
ARTERIOGRAPHY
MR angiography

37. HISTOPATHOLOGY:

38. TYPE OF DISEASES
•CONGENITAL / HEREDITARY
•ACQUIRED:
•INFLAMMATION (INFECTION)
•NEOPLASMA
•TRAUMA
•DEGENERATIVE

39. UPJ Stenosis Vessel Abberant Renal Cyst
CONGENITAL ANOMALIES
Hypospadias Number Anomalies Policystic Kidney Disease

40. TRAUMA
Urethral Trauma
(Urethral Discharge)
Kidney Trauma

41. Testicular CA Penile CA Bladder CA
CARCINOMA OF THE UROGENITAL ORGANS

42. TREATMENT MODALITY IN URINARY SYSTEM
•DRUG AND LIFE STYLE MODIFICATION
•MINIMAL INVASIVE SURGERY : ENDOUROLOGY, LAPAROSCOPIC SURGERY
•OPEN SURGERY

43. END STAGE RENAL FAILURE TREATMENT
Hemodialysis (HD)
Continuous Ambulatory
Peritoneal Dialysis (CAPD)
Kidney Transplantation

44. ENDOUROLOGIC OPERATIONS
TRANSURETHRAL RESECTION OF THE
PROSTATE (TURP)
TRANSURETHRAL RESECTION OF THE BLADDER
(TURB)

45. ESWL PCNL
URS Vesicolithotripsy

46. TREATMENT : LASER (ND Y,
HOLMIUM,THULIUM)
Urologic Applications:
-Intracorporeal Lithotripsy
-Incision of Ureteral and
Urethral Strictures
-Ablation of Superficial TCC
-Bladder Neck Incision /
Prostate Resection

47. OPERATIVE TREATMENT:
LAPAROSCOPIC OPERATION

48. OPERATIVE TREATMENT:
OPEN OPERATION

49. THANK YOU
DANKE
ARIGATOU
TERIMA KASIH