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30 Cards in this Set
- Front
- Back
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1. What are the ssx of nephrolithiasis?
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a. Renal colic
b. Hematuria c. Vague abdominal pain d. Dysuria, frequency, urgency |
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2. Where does the formation of the stone begin? When do they become symptomatic?
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a. Renal papillae
b. Pass into the ureter/ureteropelvic junction |
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3. What size of stone usually passes spontaneously?
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a. 5mm
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4. What are the risks for nephrolithiasis?
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a. Prior nephrolithiasis
b. FHx c. Enhanced enteric oxalate absorption d. Frequent upper UTI e. HTN-- 2x f. Acidic urine |
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5. What are the most common types of stones?
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a. Calcium oxalate
b. Uric acid c. Cystine d. Struvite |
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6. What organisms cause struvite stones?
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a. Proteus
b. Klebsiella |
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7. How do you dx nephrolithiasis?
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a. Non-contrast helical CT
b. Very fine cuts |
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8. What is the drawback of abdominal plain film to dx nephrolithiasis?
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a. Will only see radiopaque stones→ Ca, struvite, cystine
b. Will miss uric acid stones |
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9. How do you tx nephrolithiasis?
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a. Pain control
b. Hydration w/ saline c. Strain urine and identify stone d. Lithotripsy→ shock wave or ureteroscopic |
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10. When should a urologist be consulted in nephrolithiasis?
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a. Septic patients
b. Unrelenting pain c. Anuria d. Acute renal failure |
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11. What are the risk factors for calcium stone formation?
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a. Urinary→ low volume, high Ca, high oxalate, low citrate
b. Anatomic→ horseshoe kidney c. Diet→ low fluid intake, high oxalate, high animal protein d. Other→ hyperPTH, gout, DM |
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12. What is the most common metabolic abnormality leading to nephrolithiasis?
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a. Idiopathic hypercalciuria
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13. What is Dent’s disease?
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a. X-linked
b. Characterized by hypercalciuria, nephrocalcinosis, progressive kidney failure |
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14. What are the signs of mineral dysmetabolism?
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a. Hypercalciuria without hypercalcemia
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15. What urinary calcium excretions point to idiopathic hypercalciuria?
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a. Men>300 mg/d
b. Women> 250 mg/d |
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16. What is hyperoxaluria?
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a. Increased oxalate levels
b. End product of glycine and ascorbic acid |
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17. What can cause a decrease in absorbed dietary oxalate?
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a. Increased dietary calcium
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18. How does hypocitraturia lead to nephrolithiasis?
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a. Citrate is an inhibitor of crystal formation
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19. What are the causes of hypocitraturia?
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a. Chronic metabolic acidosis
b. High animal protein diet c. RTA |
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20. What causes hyperuricosuria?
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a. Excessive intake of purine from meat, fish, and poultry
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21. How do you tx hyperuricosuria?
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a. Allopurinol
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22. What is the characteristic appearance of calcium oxalate monohydrate crystals?
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a. Coarse, needle-shaped crystals
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23. With what condition are struvite stones associated?
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a. Chronic UTIs→ proteus/klebsiella
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24. How are struvite stones formed?
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a. Urease degrades urea to NH3 and CO2
b. NH4 is formed and precipitates with PO4 and Mg c. Usually mixed |
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25. What happens to a struvite stone if it is not treated?
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a. Staghorn calculi→ must be removed surgically
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26. What are the risk factors for uric acid stones?
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a. Gout
b. Idiopathic uric acid lithiasis c. Low urine pH d. Dehydration e. Lesch-Nyhan syndrome |
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27. How do you tx uric acid stones?
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a. Raise urine pH
b. Allopurinol |
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28. What causes cystine stones?
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a. Autosomal recessive
b. Impaired renal and intestinal cystine transport |
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29. How is cystine detected in the urine?
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a. Na nitroprusside test
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30. How do you tx cystine stones?
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a. High fluid intake day and night
b. Low salt diet c. Urinary alkalization d. Captopril DOC |
