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5 Cards in this Set

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  • Back

stone composition
Calcium Oxalate (75%)
monohydrate--dumbbell shape

Magnesium Ammonium Phosphate (Struvite)coffin lid shape --associated with infection w/ urea-splitting bacteria (proteus), often form large staghorn calculi

Uric acid stones (powdery)
--gout, leukemia & pt w/ acidic urine & Chrohn pt's

Cystine Stones (hexagonal)

Cystine & struvite stones are always abnormal & require further inversigation
Etiology of Calcium Oxalate Nephrolithiasis
Idiopathic renal hypercalciuria--tx w/ Thiazide

Increased Ca2+ absorption-- excess vitamin D, Sarcoid or granulomatous disease



Multiple Myeloma--mets to bone
Presentation of Neprolithiasis
Backache radiating into abdomen--may migrate towards lower abdomen. Hematuria
Nausea,diaphoresis, vomiting & anorexia. Pain unrelieved by positional changes
Drugs associated with calculi
antacids w/ silica--silicate stones

Carbonic Anhydrase Inhibitors--calculi

Acyclovir--crystalluria-- calculi

Antineoplastic drugs
Radiologic Studies for Stones
KUB (kidney urether bladder) films--85% of stones have calcium and can be seen w/ KUB

Ultrasound--operator dependent- useful when KUB +

IVP (intravenous pyelogram)
"gold standard"

retrograde pyelogram--for small radiolucent stones

CT-seldom used (slice may miss it)

MRI--not used