Kidney Stones Flashcards
Is kidney stones more common in M or F?
M
What is the M peak age for stones?
30
What is the F peak age for stones?
35
55
What are the different stone types?
Calcium oxalate Calcium oxalate and phosphate Triple phosphate Calcium phosphate Uric acid Cystine
What are the symptoms of kidney stones?
Renal pain (fixed to loin) Ureteric colic Dysuria Haematuria Urinary infection Loin tenderness Pyrexia
What first line investigations should be done for kidney stones?
Bloods FBC U&E's Creatinine Urine analysis Urine culture 24hr urine collection
What is the radiological investigations for stones?
CT KUB
USS
What is the first line radiological investigation for stones?
CT KUB
What are the surgical indications for stones?
Obstruction
Recurrent gross haematuria
Recurrent pain and infection
Progressive loss of kidney function
What are the different surgeries for stones?
Open
ESWL
Endoscopic
Ureteroscopy
What does ESWL stand for?
extracorpeal shockwave lithotripsy
What is the commonest surgery for stones?
ESWL
What are the indications or open surgery?
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
What contraindications are there for PNCL?
Uncorrected coagulopathy
Active UTI
Obesity of unusual body habitus
What are potential complications of PCNL?
AV fistula Pseudoaneurysm Minor tears Bruising Swelling Injury to adjacent organs Infection
What is ESWL the common first line treatment for?
Rena and ureteric calculi
When is ESWL not first line?
When stone >2cm
For which stones is ESWL often ineffective?
Cystine
Who can ESWL not be given to?
High BP
Pregnancy
On anticoagulants
When will you stop using ESWL as treatment?
When not effective over 2 treatments
What has revolutionised the diagnosis for ureteric stones?
IVU
What are the indications for ureteroscopy?
Severe obstruction
Uncontrollable pain
Persistent haematuria
Failed EWL
What is ureteroscopy?
Ureteroscope is inserted through urethra
Try to remove the stone there or use laser to break it down
What are potential complications of urteroscopy?
Haematuria FEver Small/major perforation Vesico-ureteric perforation Stricture formation
What are the symptoms of bladder stones?
Suprapubic pain Penile pain Dysuria Persistant UTI Frequency Haematuria Sudden interruption of urinary stream Usually secondary to outflow obstruction
What percentage of renal tract stones are likely to be visible on plain x-ray?
90%
What is the most sensitive imaging modality to detect renal tract calculi?
CT KUB
