20 - Urosurgery

Question 1

Enumerate (3) risk factors for nephrolithiasis:

Answer 1

• poor fluid intake
• hypercalcemia
• renal tubular acidosis

Question 2

Identify: stones radiolucent in abdominal x-rays:

Answer 2

uric acid stones

Question 3

Identify: stones associated with urea-splitting bacteria:

Answer 3

struvite stones

Question 4

Staghorn calculi are associated with this species of bacteria:

Answer 4

Proteus mirabilis

Question 5

Symptom associated with stones in the proximal 1/3 of ureter:

Answer 5

flank pain radiating to the groin

Question 6

Symptom associated with stones in the middle 1/3 of ureter:

Answer 6

anterior lower quadrant pain

Question 7

Symptom associated with stones in the distal 1/3 of ureter:

Answer 7

bladder irritative symptoms

Question 8

Threshold of CBC count that implies possibility of pyelonephritis:

Answer 8

> 15

Question 9

stones associated with urine pH > 7

Answer 9

struvite stones

Question 10

stones associated with urine pH < 5

Answer 10

uric acid stones

Question 11

Identify: stones radioopaque in abdominal x-rays:

Answer 11

calcium stones

Question 12

Identify: This diagnostic test is very sensitive for detecting calculi of any composition in any location in the urinary tract:

Answer 12

non-contrast enhanced (helical) CT (CT stonogram

Question 13

When is nephrectomy indicated in managing nephrolithiasis?

Answer 13

when the stone-bearing kidney has <20% function

Question 14

What type of stones (2) are associated with gout?

Answer 14

uric acid or calcium stones (because of acidic urine and uricosuria)

Question 15

What type of stones (2) are associated with chronic diarrhea?

Answer 15

uric acid or calcium stones (because of dehydration, hypocitrauria, and enteric hyperoxaluria)

Question 16

Enumerate: urease-positive bacteria (3) that are associated with the formation of struvite stones:

Answer 16

• Proteus
• Klebsiella
• Pseudomonas

Question 17

Enumerate: (3) stone-provoking medications:

Answer 17

• acetazolamide - alkalinizes the urine
• calcium supplements or vitamin D - hypercalciuria
• Vitamin C - metabolized to oxalate causing calcium oxalate formation

Question 18

Term for incomplete stone fragmentation as a complication of ESWL:

Answer 18

streinstrasse

Question 19

Size of stones that rarely pass spontaneously:

Answer 19

> 6 mm

Question 20

Identify: type of stone that cannot be broken down to shock-wave lithotripsy:

Answer 20

cystine stones

Question 21

procedure for large or complex renal or ureteral calculi

Answer 21

Percutaneous nephrectolithotomy (PCNL)

Question 22

Salvage treatment of stones for rare cases of endoscopic or SWL failure:

Answer 22

Laparoscopic or open stone removal