4/30(月)
◆今日の気持ち
(膠原病科 今日で一ヶ月)
●今の目標
・きっちり仕事する
●今日の新患・診断
●今日の病院滞在時間
●今日行ったこと・見たこと・知ったこと
・尿中赤血球円柱→糸球体腎炎
・腎炎??で考えるべきは
血管炎、腫瘍、薬剤、感染(急性・慢性…肝炎など)、遺伝性、アミロイドーシス、電解質、HT、DM、解剖学的異常
・ACEI, ARBで血圧上がったら…
腎高血圧。腎血流が下がることで血圧上がる悪循環に入ることが
・RTA
T型は腎石灰化あり
・尿anion gap
Na+K-Cl
(HCO3が尿には出ないがKが出る)
陰性なら、NH4が大量に出ているということ →下痢・アシドーシス
陽性なら →尿細管性アシドーシス
…ケトン体がでているときは使えない
・代謝性アシドーシスでは
Kが見かけ、あがる
・キューピッドの弓徴候
膵炎で臍のところがへっこむそうな。ほんと??
・Pancoast腫瘍(肺尖部に腫瘍)
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