Kidney Stones

Question 1

4 Radio-Opaque Stones

Answer 1

Ca Oxalate
Cystine
Triple Pi
Ca Pi

Question 2

Radiolucent Stones (major and genre)

Answer 2

Uric Acid

Drug stones

Question 3

3 Acidic Stones

Answer 3

Ca Oxalate
Uric Acid
Cystine

Question 4

2 Alkalotic Stones

Answer 4

Triple Pi

Ca Pi

Question 5

Ca Oxalate Shape

Answer 5

Envelopes and Dumbells

Question 6

Uric Acid Shape

Answer 6

Rhomboids/Stellate

Question 7

Cystine Shape

Answer 7

Hexagon - “Benzene Ring” (yellow and sulfur-y)

Question 8

Triple pi Shape

Answer 8

Rectangles - “Coffins”

Question 9

Ca Pi Shape

Answer 9

Kinda like shards

Question 10

Staghorn Stones (2 most likely and differentiation)

Answer 10

Triple Pi then Cystine (Alkalotic vs. Acidic pH)

Question 11

Ca Oxalate Recurrence

Answer 11

More likely after 1 but usually 5+ years until 1st recurrence, then starts speeding up for subsequent

Question 12

2 Mechs of CaOx stone Formation

Answer 12

Homogenous (too much reactions)

Heterogenous (epitaxy) - catalyzed by other stone, like uric acid

Question 13

Most Common Cause of CaOx Stones

Answer 13

Hypercalciuria (usually by excessive Na intake)

Question 14

Primary Hyperparathyroidism

Answer 14

Usually causes Ca Pi stones bc hypercalciuria

Question 15

2 Causes of Hyperoxaluria

Answer 15

Vitamin C -> ascorbic acid -> increases urinary oxalate

Short Bowel Syndrome/Gastric Bypass -> fats combine w/ Ca, so don’t bind oxalate in gut, increased absorption

Question 16

Hyperuricosuria

Answer 16

Increased animal prot increases CaOx formation

Question 17

3 Major Stone Inhibitors

Answer 17

Citrate - binds Ca competing w/ oxalate
Magnesium - binds growth plate and stop formation
Phosphorous - competes w/ oxalate in acidic urine

Question 18

5 Tx for CaOx

Answer 18

Decrease Na intake <150/day
Do NOT decrease dietary Ca
Thiazide dius reduce urine Ca
Avoid Vitamin C/oxalate foods
Potassium citrate

Question 19

Cystinuria

Answer 19

AR disorder of dibasic amino acid transport. Presents in 2nd/3rd decade, bilateral, w/ staghorn

Question 20

3 Tx for Cystinuria

Answer 20

Potassium citrate
Diamox for alkalinization
D-Penicillamine chelates cysteine

Question 21

Triple Pi Stone Cause

Answer 21

Urinary tract infection w/ G- -> produce urease which causes