Kidney Stones

Question 1

___ weather increases stone formation

Answer 1

hot

Question 2

____% recurrence risk at 5 years

Answer 2

50-60

Question 3

Immobilization leads to hyper____

Answer 3

hypercalciuria

Question 4

_____ imaging prior to PCNL

Answer 4

Non-con CT

Question 5

MUST obtain ____ before intervention to stratify infection risk

Answer 5

UA

Question 6

Ureteral stones <10mm distally should be offered ____

Answer 6

alpha-blockers

Question 7

Re-imaging prior to surgery if stone ____ OR would change management

Answer 7

moved/passed

Question 8

Offer stone treatment if MET is not successful after ____

Answer 8

4- weeks

Question 9

____ is the procedure with lowest morbidity & complication rate

Answer 9

ESWL

Question 10

1st line therapy for mid or distal ureteral stones - ____

Answer 10

URS

Question 11

____ is recommended to treat cystine or uric acid ureteral stones

Answer 11

URS

Cystine - not well broken down by ESWL

Uric Acid - radiolucent

Question 12

Reasons to not stent

1. No ____ injury
2. No ____ stricture
3. _____ contralateral kidney
4. ____ AKI
5. No planned 2nd stage URS

Answer 12

1. No ureteral injury
2. No ureteral stricture
3. Normal contralateral kidney
4. No AKI
5. No planned 2nd stage URS

Question 13

Pre-stenting should ____ be performed

Answer 13

NOT

Question 14

Meds for stent discomfort

Answer 14

alpha-blocker

anti-muscarinics

Question 15

With infection the first priority is _____

Answer 15

decompression of upper tract with stent vs PCN

Question 16

In patients with <20mm of non-lower pole stones, you can offer ___ OR ____

Answer 16

ESWL or URS

Question 17

Total stone burden >2 cm should be treated with ____

Answer 17

PCNL

Question 18

For symptomatic, non-obstructing stones, you can off ____

Answer 18

stone treatment

Question 19

May perform ____ when stone filled kidney has negligible function

Answer 19

nephrectomy

Question 20

Offer ___ or ___ with symptomatic, <10mm lower pole stones

Answer 20

ESWL or URS

Question 21

NTs are ____ in uncomplicated PCNLs

Answer 21

optional

Question 22

Use ___ for irrigation for PCNL & URS

Answer 22

normal saline

Question 23

May prescribe ____ to facilitate stone passage s/p ESWL

Answer 23

alpha-blocker

Question 24

Do NOT use ____ with pts who have anatomic or functional obstruction

Answer 24

ESWL

Question 25

____ stones should be treated regardless of symptoms

Answer 25

Staghorn

Question 26

Children always need metabolic evaluation with a ____

Answer 26

24 hr urine

Question 27

In pediatrics with total stones >20 mm, you can offer ___ or ____ with pre-stenting

Answer 27

PCNL

ESWL with pre-stenting

no distinction between lower pole

Question 28

In pregnant pts with ureteral stones, you can offer ____ to pts who fail observation

Answer 28

URS

Question 29

Safest time for stone surgery in pregnancy is ____ trimester

Answer 29

2nd

Question 30

When fragments are present, should offer ____ treatment to render stone free

Answer 30

endoscopic

Question 31

Abort procedure and obtain culture if ____ urine is encountered

Answer 31

purulent

Question 32

In anti-coagulated pts, ____ is 1st line stone therapy

Answer 32

URS

Question 33

Skin to stone distance >____cm is associated with SWL failure

Answer 33

10

Question 34

BMI >____ may prohibit ESWL

Answer 34

30

Question 35

Treatment for 1.8cm lower pole stone in horseshoe kidney

Answer 35

PCNL

Question 36

With ruptured calyx, you can ____

Answer 36

observe

Question 37

Stones resistant to ESWL

Answer 37

CaOx Monohydrate
Brushite
Cystine

Question 38

Risk factors for uric acid stone formation

Answer 38

T2DM

Obesity

Question 39

Risk factors for hydroxyapatite stone formation

Answer 39

RTA
HyperPTH
Medullary sponge kidney
Carbonic anhydrase inhibitor

Question 40

Pharmacologic therapy for hypercalciuria

Answer 40

Thiazide diuretic

Question 41

Pharmacologic therapy for hyperuricosuria

Answer 41

Allopurinol

in recurrent Ca++ stone formers

Question 42

Pharmacologic therapy for hypocitraturia

Answer 42

Potassium Citrate

Question 43

Repeat 24 hr urine s/p ____ of dietary or medical intervention

Answer 43

6 months