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Year2 Renal > Exam 3- Pales- nephrolithiasis > Flashcards

Exam 3- Pales- nephrolithiasis Flashcards

1
Q

Are kidney stones more likley in men or women

A

men

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2
Q

What are the 4 types of stones

A

Calcium-80%
uric acid -5-10
strvite 10-15
cystine less than 1%

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3
Q

what causes stones usually

A

supersaturation

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4
Q

ris factors for Ca stones

A 
hypercalciuria
hyperoxaluria
hypocitraturia
high urine pH
low urine volume
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5
Q

what causes hypercalciuria

A 
higher salt in diet
higher non-dairy animal protein diet
high sucrose content in diet
hyperparathyroidism
hypercalciuric hypocalcemia
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6
Q

why is RTA I associated with calcium stones

A

high urine pH

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7
Q

what cause hyperoxaluria

A

increased intake in high oxalate containing foods

decreased oral Ca intake

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8
Q

why does a high Ca diet help with Ca stones

A

bind oxalate in diet, then exccreted with stool

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9
Q

What are causes of uric acid stones

A

hyperuricemia, hyperuricuria

low urine pH

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10
Q

what conditions cause hyperuricemia and uria

A

gout
polycythemia vera
tumor lysis

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11
Q

what conditions cause a low urine pH

A

obesity, DM II, high non-dairy animal protein intake

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12
Q

whta cause struvite stones

A

chronic UTI with urease producing bacteria (Proteus or klebsiella

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13
Q

what type of inheritance is cystinuria

A

autosomal recessive

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14
Q

what Sx are associated with stones

A

micro, macro hematuria

sometimes associated with UTI: fever, leukocytosis, pyruia sepsis

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15
Q

what is renal colic

A

sudden acute severe
non remitting with positional changes
abdominal or back pain
unilateral

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16
Q

how do you Dx kidney stones

A

clinical presentation
RBC WBC cyrstals
leikocytosis, ARF
imaging

17
Q

what type of imaging only show calcium

A

plain films

18
Q

What is the gold standard for renal stones

A

CT

19
Q

Ultrasound is not good for what type stone

A

ureteral

20
Q

how do you treat acute attack of kidney stones

A

pain control nausea control, propulsive therapy(Cach blocker, alpha-blocker)

21
Q

What do you treat kidney with after acute attack of large stone

A

lithotripsy for large stones, break up stones

22
Q

what is a nephrostomy

A

remove urine from kidney directly because obstruciton form stone is acute and need to buy time

23
Q

How do you prevent stones

A

change diet and fluid intake

24
Q

what labs do you order after stones

A

hypercalciuria work up

24 hr urine collection Ca urate, oxalate and citrate

25
Q

What food do you avoid in Ca stone patient

A

avoid spinach
reduce Na
restrict nondairy animal protein
increase K rich food

26
Q

What are changes to prevent uric acid stones

A

increase urine pH
reduce intake animal proteins
increase intake alkali rich foods
oral bicarb

27
Q

what medications do you use to prevent stone recurrence

A

thiazides
alloputinol for uric stones
Kcitrate
Mg which bind to oxalate and make soluble

Year2 Renal (20 decks)

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