Nephrolithiasis

The manifestations of renal calculi are extremely variable. In many instances stones are carried in the kidneys for years without producing any symptoms. More commonly, a mild infection develops in the pelvis about the stone and gradually involves the cortex of the kidney until a severe pyelonephritis develops. If the stone is large, or several are present, the infection may progress to pyonephrosis, resulting in the destruction and ultimate loss of the kidney.

The size of a calculus varies from very small gravel to a large stag-horn stone which may fill the renal pelvis. Calcium oxalate stones usually are small, dark, rough and hard, while calcium phosphate stones tend to be soft, white, chalky and frequently stag-horn in shape. Migration of a stone may cause obstruction with resultant stasis, infection and clinical manifestations. Persistent or repeated obstruction leads to pyonephrosis or hydronephrosis. When a stone enters and obstructs the ureter, renal colic occurs. There is excruciating pain which originates in the back of flank and radiates across the abdomen and into the groin, genitals and inner aspect of the thigh. There may be nausea, vomiting, sweating, frequency, urgency of urination, chills and shock. Examination reveals slight soreness over the involved kidney and ureter, spasm of the abdominal muscles, albuminuria and microscopic haematuria.

Intermittent or persistent obstruction to the flow of urine leads to stasis, infection, hydronephrosis and renal destruction if the obstruction is bilateral, anuria and uremia ensue.

POST-TEXT ASSIGNMENTS

Exercise 6. Answer the following questions on the text:

1. What may cause obstruction with resultant stasis?

2. Does persistent obstruction lead to pyonephrosis?

3. Where does the pain radiate across?

4. When does renal colic occur?

5. Is persistent obstruction a cause of stasis?

6. Is passage of vesical calculi usually complicated?

7. What may be produced by vesical calculi?

8. Is it easy to reveal cysteine stones by X-ray examination?

Exercise 7. Read the text and say whether the following statements are true to the text.

1. When a stone enters and obstructs the ureter, renal colic does not occur.

2. Intermittent or persistent obstruction to the flow of urine leads to stasis, infection, hydronephrosis and renal destruction.

3. Calcium oxalate stones usually are small, white, rough and not hard.

4. The pain in case of calculi originates in the back or flank and radiates across the abdomen and into the groin.

5. There may be only nausea and vomiting in calculi.

Exercise 8. Give English equivalents of the following word combinations:

Полная потеря, во многих случаях, мелкая галька, повторная закупорка, мучительная боль, небольшая чувствительность, почечная колика, клинические проявления, разнообразные проявления, частое мочеиспускание, разрушение почки

Exercise 9. Find in the text the missing part of the following sentences and translate the whole sentence:

More commonly, a mild infection develops in the pelvis about the stone and… .

When a stone enters and obstructs the ureter… .

Calcium oxalate stones usually are small, dark, rough and hard, while calcium phosphate stones tend to be… .

Examination reveals slight soreness over the involved kidney and ureter… .

Intermittent or persistent obstruction to the flow of urine leads to stasis… .

Exercise 10. Translate into English:

Во многих случаях камни в почках могут быть годами, не вызывая симптомов.

Размер камней разнообразен.

Движение камня может вызвать закупоривание протоков.

Почечные колики возникают в том случае, когда камень закупоривает уретру.

Почечная колика может сопровождаться тошнотой, рвотой, частым мочеиспусканием, ознобом и проч.

Стойкое закупоривание потоку мочи ведет к застою, инфекции и гидронефрозу.

Exercise 11. Make the following sentences interrogative:

The manifestations of renal calculi are extremely variable.

In many instances stones are carried in the kidneys for years.

Persistent or repeated obstruction leads to pyonephrosis or hydronephrosis.

Calcium oxalate stones usually are small, dark, rough and hard.

Migration of a stone may cause obstruction with resultant stasis.

Exercise 12. Insert modal verbs:

If the stone is large, the infection …. Progress to pyonephrosis.

You … check up your kidneys. Your urinalysis is not good.

Examination … reveal slight soreness over the involved kidney.

If the obstruction to the flow of urine is bilateral, anuria and uremia … ensue.

You … be hospitalized immediately, your condition is very severe.

Exercise 13. Explain the following terms in English:

a) pyelonephritis

b) chill

c) urine

d) albuminuria

Exercise 14. Repeat DISEASES. Choose the best answer.

1. Children with ... diseases should not be allowed to go to school.

a) constant b) contact c) infectious d) influential

2. He has ... bronchitis. He has suffered from it for many years,

a) chronic b) durable c) fatal d) mortal

3. I have been advised to take every ... against catching flu again this winter, a) precaution b) prediction c) premeditation d) prevention

4. After the outbreak of a mysterious illness, investigation revealed ..... of the town's water supply.

a)contagion b) eruption c) infiltration d) pollution

5. Apart from the ...cough and cold, I have been remarkably healthy all my life.

a) irregular b)odd c) opportune d) timely

6.Smallpox, once responsible for millions of deaths, has been virtually ... .

a) abolished b) eradicated c) erased d) exterminated

7.Unless we take immediate precautions, we shall not be able to ... the epidemic.

a)contain b) destroy c)hold d) staunch

8. Peter can't play with the children next door because he is still in ... with measles.

a) confinement b) detention c) seclusion d) quarantine

9. The outbreak of whooping cough among children under 5 has now reached

.. .proportions.

a) contagious b) endemic c) epidemic d) pathological

10. My little daughter is not allowed to play with her friends next door because one of them is suffering from a ... disease.

a) contagious b) contiguous c) touching d) transmitting

11. An illness that is caused by the mind is known as ... illness.

a) an acute b) a congenital c) a familial d) a psychosomatic

12.She suffers from a morbid fear of spiders, known to doctors as ... .

a) agoraphobia b) arachnophobia c) claustrophobia d) xenophobia

TEST

1. The manifestation of renal calculi are...

a) rare

b) frequent

c) constant

d) variab le

e) unchangeable

2. In many instances stones are carried in the kidneys for...

a) hours

b) days

c) years

d) weeks

e) several minutes

3. More commonly, a mild infection develops in the pelvis ab out the stone and involves... of the kidney.

a) nephron

b) calyx

c) cortex

d) artery

e) medulla

4. The infection may progress to...

a) cancer

b) pyonephrosis

c) nephritis

d) pyelonephritis

e) glomerulonephritis

5. Calcium oxalate stones usually are...

a) small and hard

b) large and soft

c) irregular

d) enormous

e) tiny

6. Migration of a stone may cause ... with resultant stasis, infection and clinical neanifestations.

a) ilens

b) inflammation

c) necrosis

d) cyanosis

e) ob struction

7. When a stone enters and ob structs the ureter, ... occurs.

a) inflammation

b) renal colic

c) necrosis

d) ilens

e) nephritis

8. Persistent or repeated ob struction leads to...

a) nephritis

b) pyelonephritis

c)glomeronephritis

d) pyonephrosis

e) acute inflammation.

9. Examination reveals... over the involved kidney and ureter.

a) acute pain

b) severe inflammation

c) slight soreness

d) oozing

e) no pain

10. Anuria and uremia ensue if the ob struction is...

a) unilateral

b) ilateral

c) partial

d) complete

e) long-term

15. A C U T E P Y E L O N E P H R I T I S

Exercise 1. Practice the pronunciation:

Pyelonephritis [paiələuni'raitis], dysuria [dis'juəriə], bimanual [baimænjəl],

Pyuria [pai'juəriə], bacteriuria [bæktiəri'juəriə], demonstrable ['demənstrəbl],

papillary [pə'piləri], though [∂əu]

Exercise 2. Topic vocabulary:

Shaking chill - сотрясающий озноб

Frequency – частота (мочеиспускания)

In addition to – в добавлении к

Pyuria – гной в моче

Appropriate treatment – соответствующее лечение

To be capable of – способный

Apparently – очевидно, несомненно

To provide - обеспечивать

To subside – убывать, понижаться

Exercise 3. The following are terms referring to some types of diseases. Combine the corresponding ones:

1) inflammation of the urethra; 1) glomerulonephritis;

2) bacterial infection of the kidney substance; 2) pyelonephritis;

3) a disease of the kidneys resulting in 3) urethritis;

the syndrome of acute nephritis;

4) an inherited disorder, transmitted as 4) polycystic disease of the

an autosomal dominant, in which the kidney

substance of both kidneys is largely

replaced by numerous cysts.

Exercise 4. Compose adverbs and nouns and translate them:

-LY: general, rapid, occasional, slow, permanent, apparent

-TION: add, palpate, obstruct, manifest, continue

Exercise 5. Find Russian equivalents of the following word combinations:

Generalized tenderness, lumbar region, considerable proportion, symptom-free intervals, appropriate antibiotic treatment, bimanual palpation, urinary obstruction, continuing evidence, subclinical continuation, aching pain

Exercise 6. Read and translate the text: