UltrasoundRenalHistory

{
  "resourceType" : "ActivityDefinition",
  "id" : "cc-cpg-activity-ultrasound-renal",
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative with Details</b></p><p><b>id</b>: cc-cpg-activity-ultrasound-renal</p><p><b>url</b>: <a href=\"http://hl7.org/fhir/uv/cpg/ActivityDefinition/cc-cpg-activity-ultrasound-renal\">http://hl7.org/fhir/uv/cpg/ActivityDefinition/cc-cpg-activity-ultrasound-renal</a></p><p><b>version</b>: 0.1.0</p><p><b>name</b>: UltrasoundRenalHistory</p><p><b>title</b>: Ultrasound, Renal; History: [add diagnosis, symptom(s)]; Question: [add reason for exam]</p><p><b>status</b>: active</p><p><b>experimental</b>: true</p><p><b>date</b>: Aug 5, 2019 12:02:55 PM</p><p><b>publisher</b>: Elsevier Inc</p><p><b>description</b>: Ultrasound, Renal; History: [add diagnosis, symptom(s)]; Question: [add reason for exam]</p><p><b>jurisdiction</b>: World <span style=\"background: LightGoldenRodYellow\">(Details : {http://unstats.un.org/unsd/methods/m49/m49.htm code '001' = 'World', given as 'World'})</span></p><p><b>relatedArtifact</b>: </p><p><b>kind</b>: ServiceRequest</p><p><b>code</b>: Ultrasound of bilateral kidneys <span style=\"background: LightGoldenRodYellow\">(Details : {SNOMED CT code '13301000087109' = 'Ultrasonography of bilateral kidneys (procedure)', given as 'Ultrasonography of bilateral kidneys (procedure)'})</span></p><p><b>timing</b>: </p><p><b style=\"color: maroon\">Exception generating Narrative: null</b></p></div>"
  },
  "url" : "http://hl7.org/fhir/uv/cpg/ActivityDefinition/cc-cpg-activity-ultrasound-renal",
  "version" : "0.1.0",
  "name" : "UltrasoundRenalHistory",
  "title" : "Ultrasound, Renal; History: [add diagnosis, symptom(s)]; Question: [add reason for exam]",
  "status" : "active",
  "experimental" : true,
  "date" : "2019-08-05T12:02:55-04:00",
  "publisher" : "Elsevier Inc",
  "description" : "Ultrasound, Renal; History: [add diagnosis, symptom(s)]; Question: [add reason for exam]",
  "jurisdiction" : [
    {
      "coding" : [
        {
          "system" : "http://unstats.un.org/unsd/methods/m49/m49.htm",
          "code" : "001",
          "display" : "World"
        }
      ]
    }
  ],
  "relatedArtifact" : [
    {
      "type" : "justification",
      "display" : "<p>Renal ultrasonography</p>\n\n<ul>\n\t<li>Perform ultrasonography to detect structural abnormalities when routine evaluation and urinalysis are inconclusive or to distinguish between acute and chronic kidney disease</li>\n</ul>\n\n<ul>\n\t<li>Small hyperechoic kidneys, cysts, or lesions are irregularities associated with chronic kidney disease</li>\n</ul>\n\n<ul>\n\t<li>Ultrasonography will also detect presence of stones, cysts, or masses that can affect renal function</li>\n</ul>\n\n<ul>\n\t<li>Diagnosis of chronic kidney disease requires abnormalities persisting beyond 3 months</li>\n</ul>\n\n<p>&nbsp;</p>\n\n<p>Differential Diagnosis</p>\n\n<ul>\n\t<li>Renal artery stenosis\n\t<ul>\n\t\t<li>Narrowing of the renal arteries resulting in loss of kidney function and blood pressure alteration</li>\n\t\t<li>Both renal artery stenosis and chronic kidney disease present with hypertension and reduced GFR</li>\n\t\t<li>Although also a cause of chronic kidney disease, renal artery stenosis (usually from atherosclerosis) is present before the development of kidney disease</li>\n\t\t<li>Renal bruit is indicative of renal artery stenosis</li>\n\t\t<li>Duplex ultrasonography can identify blockage in the renal artery and high velocity flow rate, indicative of renal artery stenosis</li>\n\t</ul>\n\t</li>\n</ul>\n\n<ul>\n\t<li>Neoplasm\n\t<ul>\n\t\t<li>Neoplasm of the kidney is a tumor growth in the renal cells</li>\n\t\t<li>Both diseases present with RBCs in urine</li>\n\t\t<li>Neoplasia can be differentiated by detecting tumor mass on kidney</li>\n\t\t<li>Contrast-enhanced CT scanning or ultrasonography can identify renal neoplasias, which can then be further evaluated with MRI</li>\n\t</ul>\n\t</li>\n</ul>",
      "citation" : "Chronic Kidney Disease Clinical Overview. ClinicalKey. <a href='https://www.clinicalkey.com/#!/content/clinical_overview/67-s2.0-26a91efc-ff97-4e11-b49f-c70331e79cee' target='_blank'>Source</a>",
      "url" : "http://himss19.ordersetsmanager.com/evidenceviewer/#/7CBBBE9B75E10232E05352E3610A5325/7CBBBE9B75D50232E05352E3610A5325"
    }
  ],
  "kind" : "ServiceRequest",
  "code" : {
    "coding" : [
      {
        "system" : "http://snomed.info/sct",
        "code" : "13301000087109",
        "display" : "Ultrasonography of bilateral kidneys (procedure)"
      }
    ],
    "text" : "Ultrasound of bilateral kidneys"
  },
  "timingTiming" : {
    "_event" : [
      {
        "extension" : [
          {
            "url" : "http://hl7.org/fhir/StructureDefinition/cqf-expression",
            "valueExpression" : {
              "language" : "text/cql",
              "expression" : "Now()"
            }
          }
        ]
      }
    ]
  },
  "participant" : [
    {
      "type" : "practitioner"
    }
  ]
}