Kidney Stones

Question 1

SEE DISEASES TABLE

Answer 1

SEE DISEASES TABLE

Question 2

What is required to diagnose cystinuria?

Answer 2

Stone analysis showing cystine
- Positive family history of cystinuria
- Hexagonal cystine crystals on
urinalysis (about 25% of patients)

Question 3

When should cystinuria be suspected?

Answer 3

In childs or adolescents less than 12 years old with first stones

Question 4

What is the basis behind cystinuria?

Answer 4

AUTOSOMAL RECESSIVE
- Due to inherited impairment of renal cystine transport
- Males more severely affected than females

Question 5

Describe struvite stones.

Answer 5

• More common in women
• Occurs when ammonia production increased and urine pH elevated by urease-producing organisms e.g Klebsiella
• Risk factors are dominantly UTI-based e.g neurogenic bladders, female
• Most require surgical treatment
• Treat underlying medical issure or do a metabolic evaluation
• Elevated WBC , leucocyte esterase and bacteria count
• Crystals have a coffin lid appearance and typically in alkaline urine