UltrasoundRenalHistory

@prefix fhir: <http://hl7.org/fhir/> .
@prefix owl: <http://www.w3.org/2002/07/owl#> .
@prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> .
@prefix sct: <http://snomed.info/id/> .
@prefix xsd: <http://www.w3.org/2001/XMLSchema#> .

# - resource -------------------------------------------------------------------

 a fhir:ActivityDefinition;
  fhir:nodeRole fhir:treeRoot;
  fhir:Resource.id [ fhir:value "cc-cpg-activity-ultrasound-renal"];
  fhir:DomainResource.text [
     fhir:Narrative.status [ fhir:value "generated" ];
     fhir:Narrative.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>"
  ];
  fhir:ActivityDefinition.url [ fhir:value "http://hl7.org/fhir/uv/cpg/ActivityDefinition/cc-cpg-activity-ultrasound-renal"];
  fhir:ActivityDefinition.version [ fhir:value "0.1.0"];
  fhir:ActivityDefinition.name [ fhir:value "UltrasoundRenalHistory"];
  fhir:ActivityDefinition.title [ fhir:value "Ultrasound, Renal; History: [add diagnosis, symptom(s)]; Question: [add reason for exam]"];
  fhir:ActivityDefinition.status [ fhir:value "active"];
  fhir:ActivityDefinition.experimental [ fhir:value "true"^^xsd:boolean];
  fhir:ActivityDefinition.date [ fhir:value "2019-08-05T12:02:55-04:00"^^xsd:dateTime];
  fhir:ActivityDefinition.publisher [ fhir:value "Elsevier Inc"];
  fhir:ActivityDefinition.description [ fhir:value "Ultrasound, Renal; History: [add diagnosis, symptom(s)]; Question: [add reason for exam]"];
  fhir:ActivityDefinition.jurisdiction [
     fhir:index 0;
     fhir:CodeableConcept.coding [
       fhir:index 0;
       fhir:Coding.system [ fhir:value "http://unstats.un.org/unsd/methods/m49/m49.htm" ];
       fhir:Coding.code [ fhir:value "001" ];
       fhir:Coding.display [ fhir:value "World" ]     ]
  ];
  fhir:ActivityDefinition.relatedArtifact [
     fhir:index 0;
     fhir:RelatedArtifact.type [ fhir:value "justification" ];
     fhir:RelatedArtifact.display [ fhir:value "<p>Renal ultrasonography</p>\n\n<ul>\n	<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	<li>Small hyperechoic kidneys, cysts, or lesions are irregularities associated with chronic kidney disease</li>\n</ul>\n\n<ul>\n	<li>Ultrasonography will also detect presence of stones, cysts, or masses that can affect renal function</li>\n</ul>\n\n<ul>\n	<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	<li>Renal artery stenosis\n	<ul>\n		<li>Narrowing of the renal arteries resulting in loss of kidney function and blood pressure alteration</li>\n		<li>Both renal artery stenosis and chronic kidney disease present with hypertension and reduced GFR</li>\n		<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		<li>Renal bruit is indicative of renal artery stenosis</li>\n		<li>Duplex ultrasonography can identify blockage in the renal artery and high velocity flow rate, indicative of renal artery stenosis</li>\n	</ul>\n	</li>\n</ul>\n\n<ul>\n	<li>Neoplasm\n	<ul>\n		<li>Neoplasm of the kidney is a tumor growth in the renal cells</li>\n		<li>Both diseases present with RBCs in urine</li>\n		<li>Neoplasia can be differentiated by detecting tumor mass on kidney</li>\n		<li>Contrast-enhanced CT scanning or ultrasonography can identify renal neoplasias, which can then be further evaluated with MRI</li>\n	</ul>\n	</li>\n</ul>" ];
     fhir:RelatedArtifact.citation [ fhir:value "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>" ];
     fhir:RelatedArtifact.url [ fhir:value "http://himss19.ordersetsmanager.com/evidenceviewer/#/7CBBBE9B75E10232E05352E3610A5325/7CBBBE9B75D50232E05352E3610A5325" ]
  ];
  fhir:ActivityDefinition.kind [ fhir:value "ServiceRequest"];
  fhir:ActivityDefinition.code [
     fhir:CodeableConcept.coding [
       fhir:index 0;
       a sct:13301000087109;
       fhir:Coding.system [ fhir:value "http://snomed.info/sct" ];
       fhir:Coding.code [ fhir:value "13301000087109" ];
       fhir:Coding.display [ fhir:value "Ultrasonography of bilateral kidneys (procedure)" ]     ];
     fhir:CodeableConcept.text [ fhir:value "Ultrasound of bilateral kidneys" ]
  ];
  fhir:ActivityDefinition.timingTiming [
     fhir:Timing.event [
       fhir:index 0;
       fhir:Element.extension [
         fhir:index 0;
         fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/cqf-expression" ];
         fhir:Extension.valueExpression [
           fhir:Expression.language [ fhir:value "text/cql" ];
           fhir:Expression.expression [ fhir:value "Now()" ]         ]       ]     ]
  ];
  fhir:ActivityDefinition.participant [
     fhir:index 0;
     fhir:ActivityDefinition.participant.type [ fhir:value "practitioner" ]
  ].

# - ontology header ------------------------------------------------------------

 a owl:Ontology;
  owl:imports fhir:fhir.ttl.