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8 Cards in this Set
- Front
- Back
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Analgesia |
Morphine NSAID (ketorolac) |
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Acute medical management for renal or ureteric colic? |
Conservative therapy: Hydration Analgesia Antiemetics |
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Complication factors? |
Urosepsis Intractable pain and/or vomiting Impending acute renal failure Obstruction of a solitary or transplanted kidney Bilateral obstruction |
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Management for urospesis? |
Obstruction + infection! Urinary calculi + fever + other signs of infection = emergency urologic consultation for drainage (stent or percutaneous nephrostomy tube) and IV Abx Complication - septic shock |
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Medical expulsive therapy (MET) |
Alpha blockers (tamsulosin, alfuzosin, silodosin) MOA: ureteric relaxation of smooth muscle and antispasmodic activity of the ureter leading to stone passage Contraindicated: planned cataract surgery —> floppy iris syndrome Use: may increase ureteral stone passage rate and decrease time to stone passage, particularly in distal ureteral stones <10mm in size Escalation of treatment: after 4-6 week trial of MET —> patients should undergo definitive surgical management |
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Surgical management is indicated when? |
Presence of persistent obstruction Failure of stone progression Sepsis Persistent or increasing colic |
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Conservative treatment follow up |
Spontaneous passage should occur within 4-6weeks Period imaging- ultrasound KUB or CT abdomen/ pelvis |
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Large stones 10-20mm management |
Extracorporeal shock wave lithotripsy (ESWL) Uteroscopy Percutaneous nephrolithotomy (with poor predictive outcome, obese, stone >20mm) |
