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Endo-Renal > Case 4 > Flashcards

Case 4 Flashcards

1
Q

Which of the following predispose to stone formation?

a. gastric bypass surgery
b. hyperthyroidism
c. hypertension
d. reduced bone mineral density

A

A

predispose to stone formation: gastrointestinal malabsorption (Crohn’s dse, gastric bypass surgery), primary hyperparathyroidism, obesity, t2dm, distal tubular acidosis

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2
Q

Which of the following is not likely to be seen in individuals with a history of nephrolithiasis?

a. hypertension
b. hypothyroidism
c. gout
d. reduced bone mineral density

A

B

hypertension, gout, cvd, cholelithiasis, reduced bone mineral density, ckd

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3
Q

Which of the following is associated with increased risk of stone formation?

a. oxalate
b. calcium
c. potassium
d. phytate

A

A

increased risk of stone formation:

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4
Q

The following increases the risk of stone formation following the higher intake of animal protein, except:

a. increased excretion of calcium
b. increased excretion of uric acid
c. decreased urinary excretion of citrate
d. decreased excretion of oxalate

A

D

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5
Q

Which of the following does not increase the risk of stone formation?

a. higher urine calcium excretion
b. higher urine oxalate excretion
c. higher urine citrate excretion
d. higher urine levels of uric acid

A

C

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6
Q

Renal colic may be confused with which of the following if the stone is lodged at the right ureteral pelvic junction.

a. acute pyelonephritis
b. acute diverticulitis
c. acute appendicitis
d. acute cholecystitis

A

D

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7
Q

Urologic intervention should be postponed unless the following occurs, except:

a. evidence of UTI
b. stone measuring >6mm
c. intractable pain
d. patient is able to take fluids
e. anatomic abnormality

A

D

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8
Q

Which of the following is not true about abdominal ultrasound in nephrolithiasis?

a. not as sensitive as helical CT
b. images only the kidney and possibly the proximal segment of the ureter
c. reveals a ureteral stone
d. avoids radiation

A

C

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9
Q

It is the least invasive surgical option for nephrolithiasis

a. ESWL
b. percutaneous nephrostolithotomy
c. URS
d. open stone surgery

A

A

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10
Q

It reduces calcium oxalate stone recurrence by ~50%

a. potassium citrate
b. chlorthalidone
c. allopurinol
d. tiopronin

A

B

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11
Q

It forms the largest stones

a. calcium oxalate
b. calcium phosphate
c. magnesium ammonium phosphate
d. uric acid
e. cystine

A

C

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12
Q

Urine pH <5.5 predispose to the formation which type of stone?

a. calcium oxalate
b. calcium phosphate
c. magnesium ammonium phosphate
d. uric acid

A

D

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13
Q

Renal colic that is associated to pain that radiate ipsilateral testicle/lateral labium

a. stone in the upper part of ureter
b. stone in the lower part of ureter
c. stone blocks the ureter as it crosses the right pelvic brim
d. stone that blocks the left pelvic brim

A

B

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14
Q

It is the cornerstone on which therapeutic recommendations are based

a. serum levels
b. PTH levels
c. 24-hr Urine collection
d. stone composition analysis

A

C

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15
Q

It is the predominant influence on uric acid solubility

a. urine pH
b. uric acid secretion
c. uric acid generation
d. serum uric acid level

A

A

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16
Q

It reduces urine uric acid excretion by 40-50%

a. potassium citrate
b. chlorthalidone
c. allopurinol
d. tiopronin

A

C

17
Q

It is more effective for M. genitalium infection

a. doxycycline
b. azithromycin
c. moxifloxacin
d. pristinamycin

A

B

18
Q

Most persistent urethritis is due to which organism?

a. M. genitalium
b. C. trachomatis
c. N. gonorrheae
d. HSV

A

A

19
Q

Initial treatment for patients with urethritis

a. azithromycin
b. ceftriaxone
c. both A and B
d. none of the options

A

C

20
Q

It is a common and easily modifiable risk factor for nephrolithiasis

a. urine calcium
b. urine oxalate
c. urine citrate
d. urine volume
e. urine uric acid

A

D

21
Q

It is more soluble at higher urine pH

a. calcium oxalate
b. calcium phosphate
c. magnesium ammonium phosphate
d. uric acid
e. cystine

A

E

22
Q

Majority of these stones grow at the tip of the renal papilla (Randall’s plaque)

a. calcium oxalate
b. calcium phosphate
c. magnesium ammonium phosphate
d. uric acid
e. cystine

A

B

23
Q

Irritation of the diaphragm is signaled by the phrenic nerve as pain in the area above the clavicle

a. Rovsing’s sign
b. Kehr’s sign
c. Cullen’s sign
d. McBurney’s sign

A

B

24
Q

Dietary modifications for reducing calcium oxalate stone recurrence, except:

a. Restriction of non-dairy animal protein
b. Reduce sodium intake to >2.5 g/d
c. Minimize intake of Sucrose and Fructose
d. DASH (Dietary Approaches to Stop Hypertension) Diet

A

B

25
Q

pH goal for uric acid stones

a. 6.5
b. 5.5
c. 4.5
d. 8.0

A

A

26
Q

Most common cause of congenital malformations of UTO in childhood

a. narrowing of the Ureteropelvic junction
b. abnormal insertion of the ureters into the bladder
c. all of the options
d. none of the options

A

C

27
Q

Ureteral Reimplantation or the reinsertion of the ureter into the bladder is indicated in the following conditions, except:

a. Reflux does resolve spontaneously
b. Deterioration of Renal Function
c. Recurrence of UTI despite chronic antimicrobial therapy
d. None of the options

A

D

28
Q

It evaluates bladder contractility and bladder outlet resistance during voiding

a. Pressure-flow analysis
b. Voiding Cystourethrogram
c. Ultrasound
d. Helical CT

A

A

29
Q

Risk factors for older adults in the occurrence of UTO include the following, except:

a. Benign prostatic hyperplasia (BPH)
b. Prostate cancer
c. Tumors
d. Stones
e. Posterior urethral valves

A

E

30
Q

Elective relief of obstruction is recommended in patients with the following, except:

a. Urinary retention
b. Recurrent UTIs
c. Without infection
d. Persistent pain
e. Progressive loss of renal function

A

C

Endo-Renal (4 decks)

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