Kidney stone

Question 1

Kidney stone complications

Answer 1

Can lead to hydronephrosis, pyelonephritis

Treat with fluid intake

Question 2

Calcium

Answer 2

Freq: 80%
Precipitate: at high pH(calcium phosphate) or low pH (calcium oxalate)
Xray: radiopaque

Question 3

What causes Ca2+ stone

Answer 3

Hypercalcemia: cancer, high PTH
-hyercalcinuria and stones

Oxalate crystals can result from ethylene glycol or vitamin C abuse
Tx: thiazides and citrates

Question 4

Common presentation with Ca2+ kidney stone

Answer 4

Calcium oxalate stone in a pt with hypercalciuria and nomocalcemia

Question 5

Ammonium magnesium phosphate

struvite

Answer 5

Freq: 15%
Precipitate: at high pH
Xray: radioplaque

“COFFIN SHAPED”

Question 6

What causes struvite?

Answer 6

Infections with ureas producing bugs:
proteus, staphy, klebsiella
this leads to urine alkalinization

Can form staghorn calculi and can be a nidus for UTI

Question 7

Uric acid stone

Answer 7

Freq: 5%
Precipitate: at low pH
Xray: radiolUcent

“RHOMBOID”

Question 8

Note about uric acid

Answer 8

Visible on CT and ultrasound but not xray
Strong association with hyperuricemia
Associated with high cell turnover, such as leukemia
Treat with alkalinazation of urine
Or pyrazinamide (TB drug)

Question 9

Cystine stone

Answer 9

Freq: 1%
Precipitate: at low pH
Xray: radioplaque

Most often 2/2 cystinuria
Hexagonal crystals
Treat with alkalinization of urine.