Genitourinary Flashcards
What is nephrolithiasis?
kidney stones form in the collecting ducts and can be deposited anywhere from renal pelvis to ureter
What are kidney stones made out of?
80-85% calcium oxalate
may also be calcium phosphate, uric acid, struvite, cysteine
What are the risk factors for nephrolithiasis?
- chronic dehydration
- obesity
- recurrent UTIs
- hyperparathyroidism
- history of previous stone
- slightly more common in males
What is the medical term for kidney stones?
nephrolithiasis
Describe the pathophysiology of nephrolithiasis.
- excess solute in collecting duct
- leads to super saturated urine
- favours crystallisation
What is the main complication of nephrolithiasis?
the stone can cause outflow obstruction and lead to hydronephrosis
What are the most common sites for kidney stone formation?
pelvic-ureteric junction
pelvic brim
vesico-ureteric junction
How does nephrolithiasis present?
- loin to groin colicky pain
- haematuria and dysuria
- sudden onset, early morning
- patient can’t lie still
- fever
What is the significance of a fever with kidney stones?
red flag and hints towards superimposed infection, e.g. pyelonephritis
How is nephrolithiasis diagnosed?
1st line- KUBXR
gold standard- NCCT KUB
Why is NCCT KUB better diagnostically than KUBXR for kidney stones?
KUBXR is 80% specific, NCCT KUB is 99% specific
How is nephrolithiasis treated?
- symptomatic relief: hydration, NSAIDS, IV diclofenac extreme pain
- if stones < 5mm pass spontaneously
- if stones > 5mm pass
