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17 Cards in this Set

  • Front
  • Back
most common stone?

most common cause of staghorn calculi (forms a cast in the renal pelvis)?
most common stone: Calcium

most common cause of staghorn calculi (forms a cast in the renal pelvis): Struvite -- aka magnesium-ammonium-phosphate
in a patient with an acute obstruction due to nephrolithiasis, what would you expect the creatinine to be like?
it actually stays the same

this is because the unobstructed kidney functions at up to 185% of its baseline capacity

if it does elevate this suggests a solitary kidney or disease in the other kidney that will not allow it to compensate adequately
3 most common sites of stone obstruction?
Ureteropelvic junction (UPJ): 1cm pelvis constricts into the 2 to 3 mm ureter

Pelvic Brim: where the ureter courses over both the pelvis and the iliac vessels

Ureterovesical junction (UVJ): this is the most constricted site of the ureter due to the muscular coat of the bladder
98% of what sized stones will pass within 4 weeks without intervention?

note: sixty percent of stones 5-7mm and 39% of stones >7mm will pass within 4 weeks
How does ACTUAL STONE SIZE compare to the size seen on Xray?

on CT?

CT: 88% of actual size (so its bigger in actuality)
Hematuria is present in approximately what percentage of pts with renal colic?

note: only 30% have gross hematuria
Nephrolithiasis is the most common misdiagnosis given to patients who actually have ______?
rupturing or expanding AAA


remember stones do not typically present in pts >60 y.o. and do not cause hypotension even transiently
what defines Hematuria?
5 or more RBCs per high power field
What percent of patients with flank pain and hematuria have no radiographic evidence of ureterolithiasis?
primary choice of analgesic in the tx of stone dz?

have direct action on the ureter by inhibiting prostaglandin synthesis

think ketorolac
what anti-emetic drug is indicated in stones?

dopaminergic receptor blocker in CNS

also provides pain relief
what class of medication is associated with increased rate of expulsion of a stone, decreased time to expulsion, and decreased pain?
alpha blockers (tamsulosin)

number needed to treat is 3.3

2-6 day improvement in expulsion time
average time to pass a stone 5-6mm in diameter?
7-20 days

id rather die.
Patients with hematuria, negative imaging studies and no other source require what?
outpatient urologic follow up to figure out the cause
Absolute indications for admission with a stone?
Intractable pain/vomiting


single or transplanted kidney with obstruction


hypercalcemic crisis

severe medical comorbitities
What is a common US finding in pregnant women when looking for a stone?
Physiologic hydronephrosis

more common/severe on the right
Fetal malformation rate is increased by 5% at 10 cGy when a mom is radiated...

that being said, what is the amount of radiation received when a pt gets a...


3 film IV pyelogram:

KUB: 0.05-0.15

3 film IV pyelogram: 0.15-0.20

CT: 2.2-2.5