3 - Nephrolithiasis

Question 1

the majority of kidney stones are made from what?

Answer 1

calcium

Question 2

What dietary factors increase the risk of nephrolithiasis? (5)

Answer 2

• low fluid intake
• lower dietary calcium
• low potassium
• higher animal protein
• higher oxalate

Question 3

Where does a patient complain of pain if he has an upper ureteral obstruction?

Answer 3

flank pain

Question 4

Where does a patient complain of pain if he has a lower ureteral obstruction?

Answer 4

abdominal pain or pain radiating to ipsilateral testicle

Question 5

What is the single most discriminating predictor of kidney stone in patients with unilateral flank pain?

Answer 5

• hematuria

Question 6

what is the gold standard imaging test for detection of kidney stones?

Answer 6

non contrast CT scan of abdomen/pelvis

Question 7

If a patient presents with symptomatic ureteral stone and signs of urosepsis what is the immediate treatment?

Answer 7

emergent decompression (ureteral stent or nephrostomy tube)

Question 8

What is the cut off for stone size in terms of medical vs surgical management?

Answer 8

10 mm

Question 9

What pharmacologic agent do we typically use for expulsive therapy in a patient with a kidney stone?

Answer 9

tamsulosin (Flomax)