Plenary Discussion

Terms
Costovertebral
angle
tenderness
(Pasternacky sign): having pain and
tenderness in a region of the lower
back adjacent to the spine.
Sentivity Test Urine MSU : to confirm
the diagnosis of a urine infection.
The aim is to get a specimen of urine
from the middle of your bladder

Problems
1. Why did Mrs. Piel got fever, chills,
sweating, and right waist pain?
Fever :bacteriaenter activationof
PMN
macrophageproinflammatorycytokin
es
(IL1)
endogenous
pyrogenschangethe
setofpointshypothalamusthermore
gulationsettingstemperatureincreas
ed.

chills:thermoregulation>stimulatemotor nerves>increasedmuscle tone->chills

sweating:thermoregulation>stimulates thesympathetic
nervous->activation
ofsweatglands>increasedsweatsecretion
Rightflank pain:paindue
tostretchingorrenal

2. how the interpretation of the

physical
examination?
general situation: state
temperature: febrile
pulse: tachycardia
Blood pressure: increased, but not
yet qualify as hypertension
heart and lung: normal

3. how the relationship of gender and age on

Mrs. Piel?
30 years old : the one of factor risk because of
reproductive age , because coitus will cause
bacteria to get into.
menstruation: the normal flora of the vulva and
vagina screwed
sex: women have a shorter urethra, resulting in
faster occur ascending infection
4. how the interpretation of the back and
laboratorium examination?
Pain of the back : paindue tostretchingorrenal
parenchymalrenalcapsuleirritation
Protein : proteinuria

5.whydoctorsexplainedthatMrs.Pielexperienc
edITUandadvocatetobe referred?
becausethereleukosuriaandgroups.
referred forbettermanagement
6. why are given infusion and paracetamol?
infusion: to maintain fluid intake
paracetamol: for antipyretic analgesics (to
reduce the temperature and relieve pain)
7. why the examination of urine culture and
sensitivity test MSU?
culture examination: determine the bacteria in
the urine
sensitiviti test: that is not contaminated with

8. Why did doctor give antibiotic to Mrs. Piel?

To kill the bacteria. The antibiotic is kuinolons group
(levofloxasin, ciprofloxasin), aminoglikosida and ampisilin
9. Why do the bacteria come to kidney?
Limfogen pathway and ascending infection (reflux vesika
urinaria), hematogen
10. why back pain after eating jengkol and bloody urine?
due to obstruction of the urinary tract by crystals made of
Jengkolat acid.
hematuria due to irritation of the urinarytract mucosa
whether there is a relationship lumbago one year ago to
the current situation?
11. why the swollen in young women?
because broken glomerulus-> proteinuria-> ongkotik
pressure decreases -> move to interstitial fluid -> swollen

12. how the relationship is not regularly take

medication and mother too swollen to the
current situation?
there is swollen caused by corticosteroids (ex:
prednisone). when not given corticosteroids
again, he would return swollen
This disease is a hereditary disease
13. whydoctorssaythather kidneysto leak?
because theproteinhas
alargemoleculethatnormallywas
notpassingonglomerular filtration,butcan
passandoccurproteinuria

14. what are the treatment of which is given

to young women?
diuretics: furosemide
corticosteroids: prednisone
limit intake of 0.8-1.0 g protein / kgBB / day

Jengkol
Toxicity

Mrs. Piel 30 th

1 years ago
Clog
Glomerulus

Back Pain

Inflamation

Pirogen
Alteration of
Termoleguratio
n

Febril

Activation
of Aferen
nerve

Back Pain
Given
Parasetamol and
fluid correction
Reconciliati
on

Glomeruli
Damage
Hematuri
a

Sensitivit
y test
MSU
Antibiotic

Leukosur
ia

LO
Urinanary Tract Inflammation
(Infection and Autoimunity)
Urolithiasis and Jengkol toxicity