FN: Urolithiasis: Pathophysiology and PResentation Flashcards
1
Q
Epi
A
ifetime incidence: 155
Young men
- peak age: 20-40 yrs
Sex: M>F=3:1
2
Q
Pathophysiology
A
Increased concentration of urinary solute
Reduced urinary volume
urinary stasis
3
Q
Common anatomical sites
A
- pelviureteric junction
- Crossing the iliac vessels and the pelvic brim
- Inder the vas or uterine artery
- Vesicoureteric junction
4
Q
Stone types
A
Calcium oxalate
Triple phosphate
Urate
cystine
5
Q
Calcium oxalate
A
75%
Raised risk in crohns
6
Q
Triple phosphate (struvite)
A
15%
- Ca Mg NH4 - phosphate
- May from staghorn calculi
- Association with proteus infection
7
Q
Urate:% (radiolucent)
A
Double if confirmed gout
8
Q
Cystine
A
1% (faint)
Association with Fanconi Syn
9
Q
Associated factors
A
- dehydration
- Hypercalcaemia: primary HPT, immobilisatoin
- Raised Oxalate excretion: tea, strawberries
- UTIs
- Hyperuricaemia e.g. gout
- Urinary tract abnormalities e.g. bladder diverticulae
- Drugs: frusemide, thiazides
10
Q
Presentation ureteric colic
A
- Severe loin pain radiating to the groin
- Association with n/v
- Pt. cannot lie still
11
Q
Bladder or Urethral obstruction
A
- Bladder irritability: frequency, dysuria, haematuria
- Strangury: painful urinary tenesmus
- Suprapubic pain radiating - tip of penis or in labia
- pain and haematuria worse at the end of micturition
12
Q
Other possible features
A
UTI
Haematuria
Sterile pyuria
Anuria
13
Q
Examination
A
Usually no loin tenderness
Haematuria
