GU tract problems

Question 1

What is the most likely presentation ?

• loin to groin pain, spasm like and sharp
• acute onset, unilateral
• nausea and vomiting
• hematuria
• sometimes with dysuria, frequency and straining, fevers or night sweats

Answer 1

Kidney/renal stones

Question 2

first line Ix for renal stones?

other Ixs?

Answer 2

Non- contrast CT-KUB

others include
U+Es & creatinine - AKI?
FBC, WCC and CRP - Infection?
calcium/urate - cause?
clotting - for any percutaneous intervention

Question 3

if patient with renal stones is pyrexial what should be done?

Answer 3

blood cultures (?urosepsis)

Question 4

What initial thing should be done in the mx of renal stones

Answer 4

pain relief - IM Diclofenac

Question 5

mx for asymptomatic renal stones <5mm ?

Answer 5

watchful waiting and allow spontaneous passage

can use a-blocker to aid passage

Question 6

mx for symptomatic renal stone <2cm?

Answer 6

lithotripsy

Question 7

mx for symptomatic renal stones <2cm in pregnancy?

Answer 7

ureteroscopy

Question 8

mx for complex renal calculi or staghorn calculi?

Answer 8

percutaneous nephrolithotomy

Question 9

which type of renal stone is the most common?

Answer 9

calcium oxalate stones

Question 10

how can we prevent oxalate stones?

Answer 10

cholestymine and pyroxidone

Question 11

what kind of stone are staghorn calculi ?

Answer 11

triple phosphate stones/struvite

Question 12

which stones are radio-lucent ?

Answer 12

urate and xanthine

Question 13

Semi-opaque, ‘ground-glass’ appearance

Answer 13

cystine stones

Question 14

prevention of calcium stones includes….

Answer 14

high fluid intake
thiazide diuretics
low animal protein and salt diet

Question 15

prevention of uric acid stones

Answer 15

allopurinol

alkalisation - oral bicarb