38. urolithiasis and disorders of urination

Question 1

name the stones/crystals

Answer 1

struvite
calcium oxalate
urate
cystein

Question 2

what to mention

Answer 2

generally about crystals in urine - micro, macro 
type of stone and their properties 
treatment 
mention hydronephrosis 
urethrolithiasis 
abnormal urination - nerv-nonnerve etc

Question 3

what stones are common

Answer 3

struvite, then oxalate

Question 4

what stones are rare

Answer 4

urate and cysteine

Question 5

microscopic crytsalluria

Answer 5

usually struvite or oxalate - BUT not nessecarily pathogenic if seen (can form in vitro)

Question 6

pathogenesis of stones

Answer 6

high amount af supersaturated urine
low water intake, high protein and mineral in food
nidus formation - crystallization center
urine stasis
less crystal inhibitors
always secondary to other

Question 7

signs according to location

Answer 7

ureter - usually no signs -> hydronephrosis
bladder - cystitis signs
urethra - emergency! can’t pee fix asap

Question 8

struvite

Answer 8

most common (female>male)
mg-ammonium-phosphate 
alkaline/neutral urine 
mostly together with UTI 
treat: low protein diet, acidify urine

Question 9

calcium oxalate

Answer 9

acidic urine
due to hypercalcuria, low citrate, high oxalate
male>female
treat: surgery!!

Question 10

urate stone

Answer 10

pathologic in urine! 
ammonium acid urate 
increased uric acid and ammonium rate 
acidic urine -> uric acid 
alkaline urine -> ammonium urate 
treat: low purine diet, alkalization, allopurinol

Question 11

cysten

Answer 11

cystinuria
male
alkalinization