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1 STEP UW Nephrology > Kidney stones > Flashcards

Kidney stones Flashcards

1
Q

pH > 7?2

A

Calcium oxalate and magnesium ammonium phosphate (struvite or triple phosphate)

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2
Q

pH < 7?2

A

Uric acid and cytine

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3
Q

Most frequent stone?

A

Calcium oxalate (in patient with hypercalciuria and normocalcemia

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4
Q

Highest radiograph opacity?

RADIOPAQUE

A

Calcium oxalate and calcium phosphate

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5
Q

Moderate radiograph opacity? RADIOPAQUE

A

magnesium ammonium phosphate (struvite or triple phosphate) and Cystine (cystine faintly radiopaque)

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6
Q

No radiograph opacity? RADIOLUCENT

A

Uric acid

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7
Q

Microscopic. Octahedron (square with X in the center)

A

Calcium oxalate

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8
Q

Microscopic. Rectangular prism (coffin lids)

A

magnesium ammonium phosphate (struvite or triple phosphate)

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9
Q

Microscopic. Yellow or red-brown diamond or rhombus

A

Uric acid

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10
Q

Microscopic. Flat, yellow, hexagonal

A

Cytine

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11
Q

Microscopic. Elongated, wedge-shaped; forms rossettes

A

Calcium phosphate

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12
Q

Calcium oxalate pH?

A

hypocitraturia

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13
Q

Cytine pH?

A

pH<7

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14
Q

Uric acid pH?

A

pH<7

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15
Q

Calcium phosphate pH?

A

pH>7

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16
Q

Magnesium ammonium phosphate (struvite) pH?

A

pH>7

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17
Q

In hypercalciuria what stone is most common?

A

calcium oxalate

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18
Q

Second most common stone?

A

struvite

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19
Q

Microscopy. Calcium oxalate?

A

Octahedron (square with X in the center)

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20
Q

Microscopy. Calcium phosphate?

A

Elongated, wedge-shaped; forms rossettes

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21
Q

Microscopy. Struvite?

A

Rectangular prism (coffin lids)

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22
Q

Microscopy. Uric acid?

A

Yellow or red-brown diamond or rhombus.

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23
Q

Microscopy. Cystine?

A

Flat, yellow, hexagonal

24
Q

Risk factor for what stone?

Hypercalciuria (hyperparathyroidysm)?

A

Calcium stones

25
Q

Risk factor for what stone?

Hyperoxalouria (malabsorbtion, low calcium diet)?

A

Calcium stones

26
Q

Risk factor for what stone?

Hypocitraturia (eg distal RTA)?

A

Calcium stones

27
Q

Risk factor for what stone?

Diet rich in Na, proteins, oxalate, and low calcium?

A

Calcium stones

28
Q 
Risk factor for what stone?
Ethylene glycol (antifreeze) ingestion?
A

Calcium oxalate

29
Q

Risk factor for what stone?

Vitamin C abuse?

A

Calcium oxalate

30
Q

Risk factor for what stone? Hypocitraturia (assoc with decr. urine pH)?

A

Calcium oxalate

31
Q 
Risk factor for what stone?
Fat malabsorbtion (eg Cronh disease)?
A

Calcium oxalate

32
Q

Diuretics rreatment of calcium stones?

33
Q

low Diet for calcium stones?

A

Low sodium diet, animal protein and oxalate intake

34
Q

incr. diet for calcium stones?

A

increase K intake; moderate calcium intake

35
Q

Citrate treatment for what?

A

Calcium oxalate

36
Q

Risk factor for what stone? recurrent Infection of urease positive bugs (proteus, saprophyticus, klebsiela)

37
Q

Risk factor for what stone?

Gout

38
Q

Risk factor for what stone? Myeloproliferative disorders (due to cell turnover)

39
Q

Risk factor for what stone? dehydration?

40
Q

Treatment of uric acid?

A

urine alkalinization, allopurinol

41
Q

for what stones allopurinol is treatment?

42
Q

Struvite treatment?

A

stone removal (staghorn), suppressive a/b (erradication of infection)

43
Q

Staghorn calculi?

44
Q

why urease+ bacterias predispose struvite?

A

urease hydrolyzes urea to ammonia –> urine alkalinization

45
Q

what stones may be nidus for UTI?

A

struvite (it creates staghorn calculi)

46
Q

sausas klimatas kuriam yra risk factor?

47
Q

Risk factor for what stone? Hereditary condition?

48
Q

Hereditary (autosomal recessive) condition in which Cystine reabsorbing PCT transporter loses function, causing cystinuria.

49
Q

When hereditary condition cause transportation dysfunction, what other substances are not transported?

A

Cystine, Ornithine, Lysine, Arginine (COLA)

50
Q

Which stones begins in childhood?

A

cystine (because its hereditary?)

51
Q

what other stones apart struvite can form stoghorn calculi?

52
Q

Sodium cyanide nitroprusside test positive?

53
Q

UW step2. Recurrent stones. Causes? 4

A

Cystinuria
Hyperparathyroidims (calcium oxalate stones)
Gout
Chrohns disease, bariatric surgery (Ca ox)

54
Q

UW step2. Recurrent stones.
Prevention. Dietary? 6

A

Incr. fluids (to produce >2l urine/day)
Reduce sodium (< 100 mEq/day)
Reduce proteins
Normal Ca intake (1200 md/day)
Incr. citrate (fruits and vegetables)
Reduced oxalate diet for oxalate stones (dark roughage, vit C)

55
Q

UW step2. Recurrent stones. Drug therapy for prevention? 3

A

Thiazide
Urine alkalizination (potassium citrate/bicarbonate salt)
Allopurinol (for hyperuricuria-related stones)

1 STEP UW Nephrology (14 decks)

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