Kidney Stones

Question 1

medullary sponge kidney

interstitial crystallization

Answer 1

nephrocalcinosis

Question 2

stone forming diseases and drug related disorders >

Answer 2

neprholithiasis / urolithiasis

Question 3

in neprhocalcinosis, crystal components found in

Answer 3

body of kidney (vs renal pelvis)

Question 4

majority of kidney stones made up of

Answer 4

calcium oxilate

Question 5

struvite cyrstals

Answer 5

mg amonium phosphate - dependent on bacteria in urine raising pH

Question 6

drugs with high stone causing rate

Answer 6

indinavir

acyclovir

triamterene

sulfamethoxazole

Question 7

genetic stone causing disease stone make-up

cystinuria

Answer 7

l-cystine

Question 8

genetic stone causing disease stone make-up

primary hyperoxalosis

Answer 8

calcium oxalate

Question 9

genetic stone causing disease stone make-up

dent disease

Answer 9

calcium oxalate or calcium phosphate

Question 10

genetic stone causing disease stone make-up

familal hypomagnesemia with hyper calcimia and neprhocalcinosis

Answer 10

calcium, phosphate

Question 11

genetic stone causing disease stone make-up

adenosine phosphosribosyltranferase deficiency

Answer 11

2-8 dihydroxyyadenine

Question 12

genetic stone causing disease stone make-up

distal renal tubular acidosis

Answer 12

calcium phosphate

Question 13

mutations in L-cystine stone disease

Answer 13

type A - SLC3A1 recessive, proximal tubule S3

type B SLC7A9 - incompletely dominant, transporter proximal tubule

Question 14

rare recessive disorders of liver enzymes leading to excessive endogenous oxalate synthesis

Answer 14

primary hyperoxalosis / hyperoxaluira

Question 15

stone risk factors (non-diet)

Answer 15

previous renal disease

IBD/ short gut

hyperparathyoidism

hypercalcemia of CA, sarcoid

Gout

HIV

Question 16

diet risk factors

Answer 16

low fluid

high salt

high protein

low calcium

high oxalate (spinach, beet, rhubarb, nuts, beans, chocolate, soy)

Question 17

chronic treatments, cysteine stones

Answer 17

dilution

alkalinize urine

cystine binding drugs (disulfide exchange)

(penicillamine, thipronin, captopril)

Question 18

chronic treatment uric acid

Answer 18

dilution

low protein high fruit diet

alkanize urine

xanthin oxidase inhibitors (Allopurinol, Febuxostat)

Question 19

chronic treatment struvite

Answer 19

dilution

sterilize urine (eliminate urea splitting bacteria)

remove residual stone material (surgical)

Urease inhibitors (acetohydroxamic acid)

chemolysis (hemiacidrin)

Question 20

chronic treatment calcium stones

Answer 20

dilution

maintian normal Ca intake

reduce urine calcium

Reduce urine oxalate

increase urine citrate

Question 21

in chronic calcium stones, reduce urine calcium via

Answer 21

limit Na and protein in diet

thiazide diuretic

Question 22

in chronic calcium stones, reduce urine oxalate by

Answer 22

adding calcium or limiting oxalate in diet

add pyridoxine

Question 23

in chronic calcium stones,increase urine citrate via

Answer 23

reduced protein, increased fruit

add citrate or bicarb supplements