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CVPR > CVPR First Aid: Kidney stones > Flashcards

CVPR First Aid: Kidney stones Flashcards

1
Q

Basic types of kidney stones

4 listed

A

Calcium

Ammonium magnesium phosphate

Uric acid

Cystine

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2
Q

Complications of Kidney stones

A

Can lead to severe complications such as hydronephrosis, pyelonephritis

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3
Q

Presentation of obstructed kidney stone

A

Obstructed stone presents with unilateral flak tenderness, colicky pain radiating to groin, hematuria

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4
Q

Kidney stone treatment and prevention

A

Encouraging fluid intake

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5
Q

What is the most commmon kidney stone presentation

A

Calcium oxalate stone in patient with hypercalciuria and normocalcemia

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6
Q

Calcium stone precipitates with?

A

Calcium oxalate citraturia

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7
Q

Calcium stone X-ray findings

A

Radiopaque

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8
Q

Calcium stone CT findings

A

Radiopaque

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9
Q

Calcium stone Urine crystal

A

Shaped like an envelope or dumbbell

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10
Q

Calcium stone prevalence

A

Calcium stones most common (80% of kidney stones)

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11
Q

Types of calcium stones

A

Calcium oxalate

Calcium phosphate

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12
Q

What type of calcium stone is most common?

A

Calcium oxalate

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13
Q

Calcium kidney stones associations

A

Hypocitraturia often associated with ↓ in urine pH

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14
Q

Causes of calcium kidney stone

A

Can result from:

ethylene glycol (antifreeze) ingestion

Vitamin C abuse

Hypocitraturia

Malabsorbtion (Crohn’s Disease)

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15
Q

Treatment of calcium kidney stone

3 listed

A

Thiazides

Citrate

Low-sodium diet

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16
Q

Calcium phosphate precipitates with

A

↑ pH

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17
Q

Calcium phosphate kidney stone X-ray findings

A

Radiopaque

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18
Q

Calcium phosphate kidney stone CT findings

A

Radiopaque

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19
Q

Calcium phosphate kidney stone urine crystal

A

Wedge shaped prism 582

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20
Q

Calcium phosphate kidney stone treatment

A

low-sodium diet, thiazides

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21
Q

Ammonium magnesium phosphate kidney stone precipitates with

A

↑ pH

22
Q

Ammonium magnesium phosphate kidney stone X-ray findings

A

Radiopaque

23
Q

Ammonium magnesium phosphate kidney stone CT findings

A

Radiopaque

24
Q

Ammonium magnesium phosphate kidney stone urine crystal

A

Coffin lid

25
Q

Ammonium magnesium phosphate kidney stone AKA

A

Struvite

26
Q

Ammonium magnesium phosphate kidney stone prevalence

A

15% of kidney stones

27
Q

Causes of Ammonium magnesium phosphate kidney stone

A

Caused by infection with urease (+) bugs (eg, proteus mirabilis, staphylococcus saprphyticus, Klebsiella) that hydrolize urea to ammonia → urine alkalinization

28
Q

Ammonium magnesium phosphate kidney stone special features

A

Often formm staghorn caliculi

29
Q

Treatment of ammonium magnesium phosphate kidney stone

A

Eradication of underlying infection

Surgical removal of stone

30
Q

Cystine kidney stone precipitates with

A

↓pH

31
Q

Cystine kidney stone X-ray findings

A

Faintly radiopaque

32
Q

CT findings Cystine kidney stone

A

Moderately radiopaque

33
Q

Cystine kidney stone urine crystal

A

Hexagonal

“Sixtine stones have six sides”

34
Q

Causes of Cystine kidney stone

A

Hereditary (autosomal recessive) condition in which Cysteine-reabsorbing PCT transporter loses function, causing cytinuria

Transporter defect also results in poor reabsorption of Ornithine, Lysine, Arginine (COLA)

Cysteine is poorly soluble so stones formm in the urine

35
Q

Cystine kidney stone onset

A

Typically begins in childhood

36
Q

Cystine kidney stone special features

A

Can form staghorn caliculi

37
Q

Cystine kidney stone special test

A

Sodium cyanide nitroprusside test (+)

38
Q

Treatment of Cystine kidney stone

A

Low sodium diet

Alkalinization of urine

Chelating agents if refractory

39
Q

Uric acid kidney stones precipitate with?

A

↓pH

40
Q

Uric acid kidney stones X-ray findings

A

radiolUcent

41
Q

Uric acid kidney stones CT findings

A

Minimally visible

42
Q

Uric acid kidney stones urine crystal

A

Rhomboid or rosettes

43
Q

Uric acid kidney stones prevalence

A

≈5% of all stones

44
Q

Risk factors for Uric acid kidney stones

A

↓ urine volume

Arid climates

Acidic pH

45
Q

Uric acid kidney stones are associated with?

A

Strong association with hyperuricemia (eg, gout)

Often seen in disease with high cell turnover (eg, leukemia)

46
Q

Treatment of Uric acid kidney stones

A

Alkalization of urine

Allopurinol

47
Q

Pictures of urine crystals

A

582

48
Q

What is hydronephrosis

A

Distention/dilation of renal pelvis and calyces

Dilation occurs proximal to the site of pathology

49
Q

Causes of hydronephrosis

A

Usually caused by urinary tract obstruction (eg, renal stones, severe BPH, congenital obstructions, cervical cancer, injury to uterer)

Other causes include;

retroperitoneal fibrosis

Vesicoureteral reflux

50
Q

Signs of hydronephrosis

A

Creatinine becomes elevated if obstruction is bilateral or if patient has an obstructed solitary kidney

Leads to compression and possible atrophy of renal cortex and medulla

51
Q

What is the most common renal malignancy?

A

Renal cell carcinoma

52
Q

Renal cell carcinoma most commonly occurs in?

A

Men 50-70

↑incidence with smoking and obesity

CVPR (93 decks)

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