Exam 1: Chapter 55 - Urolithiasis and Nephrolithiasis

Question 1

Urolithiasis refers to

Answer 1

stones in the urinary tract

Question 2

Nephrolithiasis refers to

Answer 2

stones in the kidney

Question 3

Stones are formed in the urinary tract when

Answer 3

urinary concentrations of substances such as calcium oxalate, calcium phosphate, and uric acid increase

Question 4

What factors favor the formation of stones?

Answer 4

Infection, urinary stasis and periods of immobility along with increased calcium concentrations in blood

Question 5

Stones in the renal pelvis may be associated with

Answer 5

intesnse depe achen in the costovertebral region

Question 6

Stones lodged in the ureter cause what?

Answer 6

Acute, excruicating colicky wavelike pain that radies down the thigh and to the genitalia

Question 7

Stones lodged in bladder usually produce symptons of

Answer 7

irritation and may be associated with UTI and Hematuria

Question 8

Diagnosis of kidney stone confirmed by

Answer 8

noncontrast CT scan

Question 9

What else may be part of the diagnostic workshop?

Answer 9

Blood Chemistries

24-Hour Urine TEst for measurement of calcium, uric acid, creatinine, sodium, pH and total volume

Question 10

Goals of management are to

Answer 10

eradicate the stonr, determine the stone type, prevent nephron destruction, control infection, and relieve any obstruction that may be present

Question 11

Immediate objective of treatment of renal or uretercal colic is to

Answer 11

relieve pain until cause can be eliminated

Question 12

What can be given to prevent pain?

Answer 12

Opioid Analgesic or Nonsteroidal Anti-Inflfammatory Drus

Question 13

Most important role to prevent kidney stones?

Answer 13

Fluid intake. should drink 8 10 oz glasses daily. Urine output excessding 2L is advisable

Question 14

For uric acid stones, patient placed on low-purine diet. Whats included in this?

Answer 14

Shellfish
anchovies, asparagus
mushrooms
organ meats

Question 15

Whats prescribed to treat cystine stones?

Answer 15

low-protein diet

Question 16

How to treat oxalate stones?

Answer 16

Dilute urine is maintained, and intake of oxalate is limited. Oxalate foods include spinach, strawberries, rhubarb, chocolate , tea, peanuts, bran

Question 17

Common interventions to remove stone?

Answer 17

Uteroscopy
Extracorporeal Shock Wave Lithotripsy (ESWL)
Endourologic

Question 18

What does Ureteroscopy involve?

Answer 18

First visualzing the stone and then destroying it.

Question 19

Uteroscopy: Acces to stone accomplished by

Answer 19

inserted a ureteroscope into the ureter and then inserted a laser through the uretoscope to fragment and remove stones

Question 20

Uteroscopy: Stent may be inserted and left for how long?

Answer 20

48 hours or more after procedure to keep the ureter patent

Question 21

Uteroscopy: Length of stay?

Answer 21

Brief, and some pateitns can be treated as outpatient

Question 22

Extracorporeal Shock Wave Lithotripsy (ESWL): What is this?

Answer 22

Noninvasive procedure used to break up stones in teh calyx of the kidney.

Question 23

Extracorporeal Shock Wave Lithotripsy (ESWL): After stones fragment to size of grains..

Answer 23

remnants of stones are spontaneously voided

Question 24

Extracorporeal Shock Wave Lithotripsy (ESWL): How does ESWL work?

Answer 24

High energy amplitude of pressure or shock wave is generated by the abrupt release of energy and transmitted through water and soft tissues

Question 25

Extracorporeal Shock Wave Lithotripsy (ESWL): When shock wave encounters a substance of different intenstivy…

Answer 25

compression wave causes the surface of the stone to fragment. REpeated shock waves reduce it to small pieces

Question 26

Extracorporeal Shock Wave Lithotripsy (ESWL):Afte r procedure, patient observed for

Answer 26

obstruction and infection resulting from blockage of the urinary tract by stone fragments

Question 27

How does Percutneous Nephrolithotomy occur?

Answer 27

Nephroscope inserted though a percutaneous route into the renal parenchyma. Depending on size, may be extracted with forceps or stone removal basket

Question 28

Puercutneous Nephrolithotomy: What is stone is too lrge?

Answer 28

Ultrasound probe inserted thorugh nephrostomy tube is used to pulverize the stone.

Question 29

How does Electrohydraulic Lithotripsy work?

Answer 29

Electrical discharge used to create a hydraulic shock wave to break up the stone

Question 30

Electrohydraulic Lithotripsy in action

Answer 30

Probe is passed through the cystoscope,and tip of lithotriptor is placed near stone.

Question 31

What is a nephrolithotomy?

Answer 31

Stone is in the kidney , this surgery is an incision into the kidney with removal of the stone.

Question 32

Stones in the kidney pelis are moved by a

Answer 32

pyelolithotomy

Question 33

stones in the ureter removed by

Answer 33

ureterolithotomy

Question 34

stones in bladder removed by

Answer 34

cystotomy

Question 35

symptoms of someone with kidney stones?

Answer 35

nausea, diarrhea, abdominal distention

Question 36

What is Hydronephrosis?

Answer 36

Obstuction in Uriary Tract. Kidey enlarges as urine collects

Question 37

Hydronephrosis Signs and Symptoms

Answer 37

Frequency
Urgency
Dysuria
Flank and Back Pain

Question 38

Hydronephoriss Therapeutic Intervention?

Answer 38

Treat Cause
RUrinary Catheter
Stents
Nephrostomy Tube (Intake and Output, No Clamping)