UltrasoundRenalHistory

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  <id value="cc-cpg-activity-ultrasound-renal"/>
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    <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>
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       value="http://hl7.org/fhir/uv/cpg/ActivityDefinition/cc-cpg-activity-ultrasound-renal"/>
  <version value="0.1.0"/>
  <name value="UltrasoundRenalHistory"/>
  <title
         value="Ultrasound, Renal; History: [add diagnosis, symptom(s)]; Question: [add reason for exam]"/>
  <status value="active"/>
  <experimental value="true"/>
  <date value="2019-08-05T12:02:55-04:00"/>
  <publisher value="Elsevier Inc"/>
  <description
               value="Ultrasound, Renal; History: [add diagnosis, symptom(s)]; Question: [add reason for exam]"/>
  <jurisdiction>
    <coding>
      <system value="http://unstats.un.org/unsd/methods/m49/m49.htm"/>
      <code value="001"/>
      <display value="World"/>
    </coding>
  </jurisdiction>
  <relatedArtifact>
    <type value="justification"/>
    <display
             value="&lt;p&gt;Renal ultrasonography&lt;/p&gt;

&lt;ul&gt;
	&lt;li&gt;Perform ultrasonography to detect structural abnormalities when routine evaluation and urinalysis are inconclusive or to distinguish between acute and chronic kidney disease&lt;/li&gt;
&lt;/ul&gt;

&lt;ul&gt;
	&lt;li&gt;Small hyperechoic kidneys, cysts, or lesions are irregularities associated with chronic kidney disease&lt;/li&gt;
&lt;/ul&gt;

&lt;ul&gt;
	&lt;li&gt;Ultrasonography will also detect presence of stones, cysts, or masses that can affect renal function&lt;/li&gt;
&lt;/ul&gt;

&lt;ul&gt;
	&lt;li&gt;Diagnosis of chronic kidney disease requires abnormalities persisting beyond 3 months&lt;/li&gt;
&lt;/ul&gt;

&lt;p&gt;&amp;nbsp;&lt;/p&gt;

&lt;p&gt;Differential Diagnosis&lt;/p&gt;

&lt;ul&gt;
	&lt;li&gt;Renal artery stenosis
	&lt;ul&gt;
		&lt;li&gt;Narrowing of the renal arteries resulting in loss of kidney function and blood pressure alteration&lt;/li&gt;
		&lt;li&gt;Both renal artery stenosis and chronic kidney disease present with hypertension and reduced GFR&lt;/li&gt;
		&lt;li&gt;Although also a cause of chronic kidney disease, renal artery stenosis (usually from atherosclerosis) is present before the development of kidney disease&lt;/li&gt;
		&lt;li&gt;Renal bruit is indicative of renal artery stenosis&lt;/li&gt;
		&lt;li&gt;Duplex ultrasonography can identify blockage in the renal artery and high velocity flow rate, indicative of renal artery stenosis&lt;/li&gt;
	&lt;/ul&gt;
	&lt;/li&gt;
&lt;/ul&gt;

&lt;ul&gt;
	&lt;li&gt;Neoplasm
	&lt;ul&gt;
		&lt;li&gt;Neoplasm of the kidney is a tumor growth in the renal cells&lt;/li&gt;
		&lt;li&gt;Both diseases present with RBCs in urine&lt;/li&gt;
		&lt;li&gt;Neoplasia can be differentiated by detecting tumor mass on kidney&lt;/li&gt;
		&lt;li&gt;Contrast-enhanced CT scanning or ultrasonography can identify renal neoplasias, which can then be further evaluated with MRI&lt;/li&gt;
	&lt;/ul&gt;
	&lt;/li&gt;
&lt;/ul&gt;"/>
    <citation
              value="Chronic Kidney Disease Clinical Overview. ClinicalKey. &lt;a href=&#39;https://www.clinicalkey.com/#!/content/clinical_overview/67-s2.0-26a91efc-ff97-4e11-b49f-c70331e79cee&#39; target=&#39;_blank&#39;&gt;Source&lt;/a&gt;"/>
    <url
         value="http://himss19.ordersetsmanager.com/evidenceviewer/#/7CBBBE9B75E10232E05352E3610A5325/7CBBBE9B75D50232E05352E3610A5325"/>
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  <code>
    <coding>
      <system value="http://snomed.info/sct"/>
      <code value="13301000087109"/>
      <display value="Ultrasonography of bilateral kidneys (procedure)"/>
    </coding>
    <text value="Ultrasound of bilateral kidneys"/>
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  <participant>
    <type value="practitioner"/>
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