Ministry of health protection of the republic of uzbekistan

TEXT A. STONES IN THE KIDNEYS
Clinical manifestation. In many instances stones are carried in the kidneys for years producing no 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 a pyelonephrosis, resulting in the destruction and ultimate loss of the kidney. Mild fever, pain, malaise and anorexia are usually present. Pus and a variable amount of albumin are present in the urine. Such symptoms as frequency of urination and mild burning pain usually accompany infection of this type. The diagnosis of renal calculi can be made by an X-ray film since most of these stones contain sufficient calcium to be radiopaque.
The most dramatic manifestation of renal calculi is renal colic brought about by the entrance of a stone into the ureter and its passage downward to the bladder. The pain described usually radiates downward toward the thigh. Hematuria is a constant symptom and is an important diagnostic sign.
While passing slowly, the stone may develop infection and pus as well as bacteria will be found in the urine. Fever is absent except the instances when the obstruction is present long enough to allow the de­velopment of infections. On rare occasions the stone produces sufficient ulceration in the ureter during its passage. Differentiation of renal colic from other acute abdominal conditions can usually be made by urine examination, and X-ray.
Treatment. Unless the renal stone is “silent”, treatment should be directed toward its removal. Most stones having entered the ureter will pass spontaneously into the bladder by the prescuption of conservative treatment such as forcing fluid, sedation, etc. During the attack of colic analgetics may be required to control the pain; if after many days, there is no evidence of progression in the descent of the stone, ureteral catheterisation may be used in dislodging it. On rare occa­sions an operation (usually extra-peritoneal with incision into the ure­ter) should be performed to remove the stone. Large stones in the kidney cannot be passed by way of the ureter and if symptoms are produced operation is necessary. If the stones are present in both kid­neys, it is usually preferable to operate first on the kidney with the poorer function, since the operation may produce a temporary anuria; if the better kidney is the one operated on first, and temporary anuria results, a fatal outcome may follow.


Exercise 5. Look through text A again and give the main symptoms and methods of treatment of nephrolithiasis.


Exercise 6. Find the answers to the following questions in text A.
1. Do stones in kidneys usually produce pyelonephritis? 2. What symp­toms help to diagnose renal calculi? 3. What is renal colic and how does it manifest? 4. When is conservative treatment used in cases of renal calculi? 5. What kidney is operated on first if the stones are present in both of them and why?


Exercise 7. Change Participle constructions into Subordinate Clauses according to the example using as, and, when, which.
Example: The usual manifestation of renal calculi is renal colic brought about by a stone in the kidney or ureter. The usual manifestation of renal calculi is renal colic which is brought about by a stone in the kidney or ureter.
1. The conditions for stone formation are: a cavity containing a fluid; the fluid having salts in solution. 2. The salts held in solution in the fluid are deposited on the foreign substances. 3. The foreign objects forming stones in the kidneys and bladder are bacteria and the small shreds of mucus. 4. All experimental patients described here had stones in the bladder. 5. When collected in polypropylene bottles the urine was kept in refrigerated lockers.


LESSON 20.
Exercise 1. Learn the following words and word combinations:
susceptible [sa 'sept bl] а чувствительный, восприимчивый (к болезни), sezuvchan, kasallikka moyil
diabetes [ dai 'bi:ti:z] n диабет, сахарная болезнь
scarlet ['ska:lit] fever n скарлатина
incompatible [ ink m'p tibl] а несовместимый, bir-biriga mos kelmaydigan
to clog [klog] v засоряться, iflosalmoq, tiqilib qolmoq
permeable ['p mibl] а проницаемый, o’tuvchi
hemoglobin [himougloubin] n гемог­лобин


Exercise 2. Look through text B in 10 minutes. 1) Tell what diseases are described in the text. 2) Find sentences with Participles I, II and define their function. 3) Translate these sentences.