history

Question 1

Flank pain location?

Answer 1

1

Question 2

Flank pain common diagnoses?

Answer 2

Question 3

Flank pain women only diagnoses?

Answer 3

ectopic pregnancy, ovarian torsion.

Also bear in mind other abdo pathology.

Question 4

Flank pain site?

Answer 4

kidney stones are unilateral but pain may radiate from loin to groin, they start with vague discomfort and become severe.

Question 5

Flank pain onset?

Answer 5

Trauma may lead to musculoskeletal pain of internal bleeding.

Question 6

Flank pain character?

Answer 6

Ureteric stones give colicky pain.

Constant pain can be a stone lodged in a kidney or an inflamed cause.

Musculoskeletal pain is an ache,

nerve impingement causes shooting pains.

Question 7

Flank pain radiation?

Answer 7

to groin is ureteric pain,

pain radiates down leg is typical of lumbar nerve root pain

Question 8

Flank pain timing?

Answer 8

Musculoskeletal back pain can last weeks,

leaking AAA doesn’t last more than a day unresolved

Question 9

Flank pain exacerbating factors?

Answer 9

Patients with peritonitis are sensitive to movement.

Question 10

Flank pain severity?

Answer 10

kidney stones are like childbirth.

Question 11

Flank pain HPC fever, rigors, night sweats?

Answer 11

inflam process like pyelonephritis or less common malignancy like renal cell carcinoma.

Question 12

Flank pain HPC dehydration?

Answer 12

predisposes to concentrated urine and therefore kidney stones.

Question 13

Flank pain HPC nausea and vomiting?

Answer 13

typical of visceral organ pathology (ureteric stones, biliary colic, appendicitis)

Question 14

Flank pain HPC haematuria?

Answer 14

kidney/ureteric stones.

Question 15

Flank pain HPC lower urinary tract symptoms?

Answer 15

urinary frequency, urgency and dysuria are typical of UTI.

Hesitancy, reduced flow, dribbling, and incomplete voiding are typical of ureteric obstruction (enlarged prostate, stones or tumours).

Question 16

Flank pain HPC cloudy, smelly urine?

Answer 16

infection

Question 17

Flank pain HPC leg weakness

Answer 17

spinal pathology

Question 18

Flank pain PMH previous kidney stone?

Answer 18

nephrolithiasis has 50% 10yr recurrence.

Question 19

Flank pain PMH recurrent cystitis?

Answer 19

recurrent UTIs predispose to stones

Question 20

Flank pain PMH atherosclerotic disease?

Answer 20

risk for AAA.

Question 21

Flank pain PMH longstanding back pain?

Answer 21

muscles, ligaments and bones.

Question 22

Flank pain PMH kidney disease?

Answer 22

Polycystic kidney disease predisposes to pyelonephritis

Question 23

Flank pain drug history?

Answer 23

Aciclovir and indinavir may crystallize in the urine.

Acetazolamide causes diuresis and potentially dehydration, predisposing to kidney stone formation.

Question 24

Flank pain family history?

Answer 24

Family history of kidney stones; indicate inherited cystinuria.