Kidney Stones

Question 1

Is kidney stones more common in M or F?

Answer 1

M

Question 2

What is the M peak age for stones?

Answer 2

30

Question 3

What is the F peak age for stones?

Answer 3

35

55

Question 4

What are the different stone types?

Answer 4

Calcium oxalate
Calcium oxalate and phosphate
Triple phosphate
Calcium phosphate
Uric acid 
Cystine

Question 5

What are the symptoms of kidney stones?

Answer 5

Renal pain (fixed to loin)
Ureteric colic 
Dysuria
Haematuria
Urinary infection 
Loin tenderness
Pyrexia

Question 6

What first line investigations should be done for kidney stones?

Answer 6

Bloods 
FBC
U&E's
Creatinine 
Urine analysis 
Urine culture 
24hr urine collection

Question 7

What is the radiological investigations for stones?

Answer 7

CT KUB

USS

Question 8

What is the first line radiological investigation for stones?

Answer 8

CT KUB

Question 9

What are the surgical indications for stones?

Answer 9

Obstruction
Recurrent gross haematuria
Recurrent pain and infection
Progressive loss of kidney function

Question 10

What are the different surgeries for stones?

Answer 10

Open
ESWL
Endoscopic
Ureteroscopy

Question 11

What does ESWL stand for?

Answer 11

extracorpeal shockwave lithotripsy

Question 12

What is the commonest surgery for stones?

Answer 12

ESWL

Question 13

What are the indications or open surgery?

Answer 13

non-functioning kidney with large stones
when for technical reasons cannot be managed with PNCL or ESWL
Failed ESWL or uteroscopy and not suitable for laparoscopic approach

Question 14

What contraindications are there for PNCL?

Answer 14

Uncorrected coagulopathy
Active UTI
Obesity of unusual body habitus

Question 15

What are potential complications of PCNL?

Answer 15

AV fistula 
Pseudoaneurysm 
Minor tears
Bruising 
Swelling 
Injury to adjacent organs 
Infection

Question 16

What is ESWL the common first line treatment for?

Answer 16

Rena and ureteric calculi

Question 17

When is ESWL not first line?

Answer 17

When stone >2cm

Question 18

For which stones is ESWL often ineffective?

Answer 18

Cystine

Question 19

Who can ESWL not be given to?

Answer 19

High BP
Pregnancy
On anticoagulants

Question 20

When will you stop using ESWL as treatment?

Answer 20

When not effective over 2 treatments

Question 21

What has revolutionised the diagnosis for ureteric stones?

Answer 21

IVU

Question 22

What are the indications for ureteroscopy?

Answer 22

Severe obstruction
Uncontrollable pain
Persistent haematuria
Failed EWL

Question 23

What is ureteroscopy?

Answer 23

Ureteroscope is inserted through urethra

Try to remove the stone there or use laser to break it down

Question 24

What are potential complications of urteroscopy?

Answer 24

Haematuria 
FEver
Small/major perforation 
Vesico-ureteric perforation 
Stricture formation

Question 25

What are the symptoms of bladder stones?

Answer 25

Suprapubic pain 
Penile pain 
Dysuria 
Persistant UTI
Frequency 
Haematuria 
Sudden interruption of urinary stream 
Usually secondary to outflow obstruction

Question 26

What percentage of renal tract stones are likely to be visible on plain x-ray?

Answer 26

90%

Question 27

What is the most sensitive imaging modality to detect renal tract calculi?

Answer 27

CT KUB