Kidney Stones Flashcards

1
Q

Why do renal stones occur?

A

Due to an imbalance between solutes and solution leading to a precipitation of the solutes out of solution

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2
Q

What is the other name for kidney stones?

A

Nephrolithiasis

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3
Q

Women are more commonly affected by kidney stones than men. T/F?

A

False - men are more commonly affected

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4
Q

What is the composition of the majority of kidney stones?

A

Calcium

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5
Q

What is the name for kidney stones which contain magnesium, ammonium and phosphate?

A

Struvite stones

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6
Q

1-2% of kidney stones are composed of…?

A

Cysteine

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7
Q

How common are uric acid kidney stones?

A

5-10% of all kidney stones

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8
Q

How common are struvite kidney stones?

A

5-10% of all kidney stones

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9
Q

What are the risk factors for nephrolithiasis?

A
BMI of over 27
Sedentary lifestyle
History of UTI
Caucasian race
Dehydration
positive family history of nephrolithiasis
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10
Q

What type of diets have a protective role in the development of nephrolithiasis?

A

High fibre, high fruit diets

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11
Q

What type of pain results from kidney stones?

A

Colicky pain from loin to groin

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12
Q

What are the associated factors of pain from kidney stones?

A

Nausea

Vomiting

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13
Q

What might be the findings of a renal examination of kidney stones?

A
Flank tenderness
Signs of infection
Obesity
Hypertension
Diabetes mellitus
Gouty tophi
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14
Q

What conditions may cause nephrolithiasis?

A
Primary hyperparathyroidism
Hypercalcaemia
Hyperoxaluria
Hyperuricaemia
Cystinuria
Hypocitraturia
Renal tubular acidosis
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15
Q

What type of kidney stones tend to develop at a pH of >7.0?

A

Calcium and struvite stones

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16
Q

What type of stones tend to develop at a pH of <6.0?

A

Cysteine stones

17
Q

How would a kidney stone smaller than 2cm be managed?

A

Expectant management

extracorporeal shock wave lithotripsy

18
Q

How is a kidney stone, larger than 2cm managed?

A

Expectant management

Percutaneous ultrasound lithotripsy

19
Q

How much time should be allowed for small ureteral stone (<7mm) to pass by themselves?

20
Q

How can large ureteral stones be removed?

A

Uteroscopic stone fragmentation

Open surgery

21
Q

What is the advantage of using ureteral stents in the management of kidney stones?

A

These drain the obstructed kidney to alleviate pain
Dilate the ureter to facilitate passage of the stone
Facilitate the performance of uteroscopic procedures

22
Q

Preventative treatments, to prevent further stone formation can be given. What preventative treatments are given in the case of calcium phosphate stones?

A

Citrate

Thiazide if hypercalciruic

23
Q

Preventative treatments, to prevent further stone formation can be given. What preventative treatments are given in the case of calcium oxalate stones?

A

Citrate
Thiazide if hypercalciruric
Low oxalate diet

24
Q

Preventative treatments, to prevent further stone formation can be given. What preventative treatments are given in the case of uric acid stones?

A

Xanthine oxidase inhibitors (allopurinol / rasburicase)

alkalinised urine to >6.0

25
Preventative treatments, to prevent further stone formation can be given. What preventative treatments are given in the case of cysteine stones?
Alkalinising urine to >7.0 | Reduce protein and sodium in the diet
26
Which type of kidney stone is commonly caused by infection?
Struvite stones
27
How does citrate reduce urinary supersaturation of calcium?
By binding to calcium and forming soluble complexes which inhibit the growth of calcium crystals
28
How can citrate inhibit the formation of irate and cysteine stones?
By having an alkalinising effect