20 - Urosurgery Flashcards
Enumerate (3) risk factors for nephrolithiasis:
- poor fluid intake
- hypercalcemia
- renal tubular acidosis
Identify: stones radiolucent in abdominal x-rays:
uric acid stones
Identify: stones associated with urea-splitting bacteria:
struvite stones
Staghorn calculi are associated with this species of bacteria:
Proteus mirabilis
Symptom associated with stones in the proximal 1/3 of ureter:
flank pain radiating to the groin
Symptom associated with stones in the middle 1/3 of ureter:
anterior lower quadrant pain
Symptom associated with stones in the distal 1/3 of ureter:
bladder irritative symptoms
Threshold of CBC count that implies possibility of pyelonephritis:
> 15
stones associated with urine pH > 7
struvite stones
stones associated with urine pH < 5
uric acid stones
Identify: stones radioopaque in abdominal x-rays:
calcium stones
Identify: This diagnostic test is very sensitive for detecting calculi of any composition in any location in the urinary tract:
non-contrast enhanced (helical) CT (CT stonogram
When is nephrectomy indicated in managing nephrolithiasis?
when the stone-bearing kidney has <20% function
What type of stones (2) are associated with gout?
uric acid or calcium stones (because of acidic urine and uricosuria)
What type of stones (2) are associated with chronic diarrhea?
uric acid or calcium stones (because of dehydration, hypocitrauria, and enteric hyperoxaluria)
Enumerate: urease-positive bacteria (3) that are associated with the formation of struvite stones:
- Proteus
- Klebsiella
- Pseudomonas
Enumerate: (3) stone-provoking medications:
- acetazolamide - alkalinizes the urine
- calcium supplements or vitamin D - hypercalciuria
- Vitamin C - metabolized to oxalate causing calcium oxalate formation
Term for incomplete stone fragmentation as a complication of ESWL:
streinstrasse
Size of stones that rarely pass spontaneously:
> 6 mm
Identify: type of stone that cannot be broken down to shock-wave lithotripsy:
cystine stones
procedure for large or complex renal or ureteral calculi
Percutaneous nephrectolithotomy (PCNL)
Salvage treatment of stones for rare cases of endoscopic or SWL failure:
Laparoscopic or open stone removal
