Renal Module > Nephrolithiasis > Flashcards

Nephrolithiasis Flashcards

(45 cards)

Study These Flashcards
1
Q

What is Nephrolithiasis?

A

Nephrolithiasis specifically refers to calculi in the kidneys, The majority of renal calculi contain calcium. The pain generated by renal colic is primarily caused by dilation, stretching, and spasm because of the acute ureteral obstruction.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the classic urinary tract symptoms of Nephrolithiasis?

A
  1. Pain
    - classic colicky “loin to groin pain or renal pain”
    - gross or microscopic Haematuria
    - Dysuria and strangury
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the systemic symptoms of Nephrolithiasis?

A
  1. Restless patient often writhing in distress
  2. Nausea, vomiting, or both (shared innervation between renal capsule and intestines)
  3. Fever and Chills (if associated with infection)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Which gender is most likely to suffer with kidney stones?

A

Men 2X more than women.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

During what season is the incidence of kidney stones greater and why?

A

Summer/dehydration or insufficient fluid intake

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Which stones are the most hazardous?

A

Because they pass into the ureters, producing pain referred to as colic as well as ureteral obstruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the 3 most likely points of kidney stone impaction?

A
  1. Ureteropelvic Junction
  2. Crossing of the Illiac vessels
  3. Entrance to the bladder
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the supportive test for kidney stone?

A

Urine analysis

  • Hypercalciuria in the absence of hypercalcemia
  • Crystals in the urine are also supportive of a diagnosis of kidney stones
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is another diagnostic tool for kidney stones?

A

A KUB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is a KUB?

A

A plain film radiograph focused on kidneys ureter and bladder.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What type of kidney stones would NOT show up on KUB?

A

Uric acid stones; are Radio lucent.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the best diagnostic tool for kidney stones?

A

Unenhanced spiral (helical) CT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What would you use ultrasound to diagnose in terms of Nephrolithiasis?

A

Hydronephrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What drug is known to cause kidney stones?

A

Idinovir - Protease inhibitor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What kind of stone does Idinovir cause?

A

Radiolucent stones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the most common type of stone?

A

Calcium oxalate usually with calcium phosphate.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the remain stones and their frequencies?

A
  1. Calcium Phosphate
  2. Magnesium ammonium phosphate (struvite)
  3. Uric Acid
  4. Cystine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the most common metabolic abnormality causing calcium stones?

A

Hypercalciuria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are other factors important in stone formation?

Study These Flashcards
A
  1. Decreased urine volume (conc the urine)
  2. Reduced urine citrate (citrate chelates Ca2+)
  3. Primary HPTH
  4. Diets high in diary products
  5. Urinary infections due to urease producers (Proteus)
20
Q

In what sub populations would one expect to see an increased incidence of Calcium stones?

Study These Flashcards
A

1.Pure Vegans and those with Crohn’s disease

21
Q

What type of stones are most common in children?

Study These Flashcards
A

Calcium Phosphate

22
Q

What are calcium phosphate stones associated with?

Study These Flashcards
A
  1. Diary products

2. Distal renal tubular acidosis

23
Q

What are Staghorn calculus or Struvite stones made of?

Study These Flashcards
A

MAP Magnesium ammonium phosphate

24
Q

What are MAP stones associated with?

Study These Flashcards
A
  1. Urease producers such as proteus

2. Very alkaline urine which smells like Ammonia

25
What size stone is most likely to be spontaneously passed?
<5mm
26
What size stones are unlikely to pass?
between 5->7mm
27
What medications increase the chances of passing stones?
1. Alpha 1 adrenergic antagonists | 2. Calcium channel blockers
28
What are the common complications of kidney stones?
1.Obstruction 2.Infections 1+2=Medical emergency
29
What are the determinants of crystallization of stones?
1. Supersaturation 2. Concentration of solute 3. Solubility of Solute 4. pH 5.Inhibitors i.e citrate 5. Nidus: another crystal from nanobacteria
30
What is the most common metabolic reason for hypercalciuria?
Increased absorption
31
What are the specific risk factors for Calcium Oxalate stones.
1. Hypercalciuria 2. Hyperoxaluria 3. pH Alkaline Urine 4. Insufficient Urinary citrate stemming from Systemic acidosis 5. Uric Acid / Gout
32
What are the metabolic risks factors for Calcareous stones?
1. Hypercalciuria 2. Hyperuricosuria 3. Hyperoxaluria 4. Hypocitriuria 5. Other (Vitamin A deficiency, hot climates, immobilization, urinary tract anomalies)
33
What are the Bacteria responsible for Struvite stones?
1. Proteus 2. Serratia 3. Klebsilla 4. Mycoplasma
34
What is the composition of Struvite stones?
Lamellated stones composed of layers of Bacterial products and mineral
35
How would you get rid of Struvite stones?
1. Physical removal 2. Antibiotics against causative agents 3. Acetohydroxamic acid a urease inhibitor but its rarely used
36
What are the Risk factor for Uric acid stones?
1. Hypercosuria - gout - dietary purine intake (animal protein) Tumor lysis - Acidic urine
37
Why do animal proteins more likely cause stones than plant proteins?
Sulhydryl groups
38
What are the causes of Cystine stones?
1. Cystine poorly soluble | 2. Cystinuria due to rare autosomal recessive disorder of dicarboxylic acid transport
39
How can one increase the solubility of cystine in urine?
1. Solubility increases with Alkaline urine pH | 2. Penicillamine increase solubility but poor side effect profile
40
What are a few drugs known to cause stones?
1. Triamtere 2. Protease inhibitors (Indinavir;atazanavir) 3. Guaifenesin 4. Silicate (overuse of antacids containing magnesium silicate) 5. Sulfa drugs
41
What is the standard treatment for Calcium stones?
1.Hydrochlorothiazide -increases renal tubule absorption of Ca2+ 2.Cellulose Phosphate Binds calcium in the intestine
42
What is the single most important factor to correct as to avoid recurrence of Kidney stones?
Low urine volume. MUST INCREASE URINE OUTPUT TO ABOUT 2 LITRES A DAY
43
What are treatments for Uric Acid stones?
1. Allopurinol | 2. Increase urinary pH (make alkaline)
44
What do you not advice patients with calcium stones to do?
Reduce calcium intake | -Calcium intake must remain normal
45
What are some recommendatio to reduce risk of recurrent stones?
1. Increase fluid intake 2. Decrease animal protein intake 3. Reduce dietary salt intake 4. Decrease dietary oxalate (Chocolate, nuts,etc) 5. Cranberry juice decreases oxalate and phosphate excretion
Renal Module
flashcards
Decks in class (29)
# Cards
Brainscape helps you reach your goals faster, through stronger study habits.
© 2026 Bold Learning Solutions. Terms and Conditions