Batu Saluran Kemih

Question 1

Batu Saluran Kemih

Answer 1

Gangguan BAK + Demam (-)

-tiasis

Question 2

KU Batu Saluran Kemih (2)

Answer 2

Nyeri pinggang
BAK berhenti

Question 3

Nyeri Pinggang (2)

Answer 3

Menjalar (-)
Menjalar (+)

Question 4

Nyeri Pinggang Menjalar (-)

Answer 4

Nefrolitiasis → nefro = ginjal

Question 5

Nyeri Pinggang Menjalar (+)

Answer 5

Ureterolitiasis → ureter

Question 6

Nyeri Pinggang Menjalar (+) (3)

Answer 6

Menjalar ke pusat (Th 10)
Menjalar ke perut bawah, selangkangan, skrotum (L1-L3)
Menjalar ke kemaluan (ujung penis, MUE) (S2-S3)

Question 7

Nyeri Pinggang Menjalar ke Pusat (Th 10)

Answer 7

💡 2P
Pusat
Proximal

Ureterolitiasis proximal

Question 8

Nyeri Pinggang Menjalar ke Perut Bawah, Selangkangan, Skrotum (L1-L3)

Answer 8

💡 2S
Selangkang
Skrotum

Ureterolitiasis medial

Question 9

Nyeri Pinggang Menjalar ke Kemaluan (Ujung Penis, MUE) (S2-S3)

Answer 9

💡 2U
Ujung Penis
M U E

Ureterolitiasis distal

Question 10

BAK Berhenti (2)

Answer 10

• Berpindah posisi lancar kembali
• Teraba benjolan

Question 11

BAK Berhenti + Berpindah Posisi Lancar Kembali

Answer 11

+ nyeri suprapubik

Vesikolitiasis

Question 12

BAK Berhenti + Teraba Benjolan

Answer 12

Uretrolitiasis → uretra

L → tarik penis
P → gosok vulva

Question 13

BAK Berhenti + Teraba Benjolan (2)

Answer 13

• Benjolan di perineum/rectum
  Uretrolitiasis posterior
• Benjolan di penis/MUE
  Uretrolitiasis anterior

Question 14

Klasifikasi Berdasarkan Jenis Batu (2)

Answer 14

Batu Asam
Batu Basa

Question 15

Batu Asam

Answer 15

💡 asAM
hitAM

Radiolusen
→ Asam urat, asam jengkolat, amonium urat, xanthin, 2,8 dihidroxiadenin, obat-obatan

Question 16

Batu Basa

Answer 16

Putih

Radioopaq
→ Calcium (oxalat, fosfat, karbonat), staghorn, struvit

Question 17

PP Awal Batu Saluran Kemih

Answer 17

Urinalisis → hematuria (>5/LPB), kristal (+)

Question 18

PP Tepat Batu Saluran Kemih

Answer 18

💡 CoBek UBi
CT BNO/IVP USG BNO

1. CT-Scan Non Kontras (NCCT) → gold standard
2. BNO-IVP → radiolusen KI: Cr >1,5
3. USG → acoustic shadow
4. BNO/foto polos abdomen/rontgen → radioopaq

Question 19

Tx Konservatif Batu Saluran Kemih

Answer 19

• Non Farmakologi
  Hidrasi
  Batu basa → minum asam
  Batu asam → minum basa
• Farmakologi
  Analgetik, tepat → spasmolitik (a-blocker non selektif)

Question 20

Tx Tindakan Batu Saluran Kemih

Answer 20

Ukuran batu

💡 Ema & Ucok Pacaran

<5 mm → konservatif
5-9 mm/batu ureter proksimal/medial → Extracorporeal Shock Wave Lithotripsy (ESWL)
10-19 mm/batu ureter distal → Uteroscopy (URS)
≥20 mm → Percutaneous Nephrolithotomy (PCNL) (pembedahan)

Question 21

Batu Semiradioopaq

Answer 21

Magnesium amonium fosfat, apatit, sistin