Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Renal / Urology > Kidney Stones > Flashcards

Kidney Stones Flashcards

1
Q

What is the real name for kidney stones

A

Nephrotic-urolithiasis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is a colic

A

Acute severe loin pain most commonly caused by an obstruction usually kidney stone
Due to peristalsis trying to push stone through

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

When is urgent intervention needed

A 
Infection
Obstruction
Impending AKI
Previous transplant
Abnormality
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What do you do as urgent intervention

A

ABCDE
Sepsis 6
Percutaneous nephrostomy or ureteric stent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are different stone types

A 
Calcium oxalate = 75% 
Calcium oxalate + phosphate
Calcium phosphate
Triple phosphate (infective) 
Uric acid 
Cysteine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is most common type of stone

A

Calcium oxalate

- Radio-opaque

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What can phosphate cause

A

Renal tubular acidosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What causes uric acid stones

A 
Metabolic disorder
Children
Tissue breakdown
Malignancy 
Low pH as breakdown purine
Gout
Ileostomy (loss bicarb)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Will you see uric acid / xanthine stones on Xray

A

No

Radio-lucent so let X-ray pass to appear black

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What causes cysteine stones

A

AR disorder of cysteine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What causes stag horn calculi and what type of urine

A

Proteus infection
Magnesium ammonium phosphate stones - Sturvie
Alkali urine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Where do stones present

A

VUJ
PUJ
Pelvic brim
Narrowest areas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How do renal stones present

A 
Renal pain - colic 
Ureteric colic - radiates to groin
As peristalsis pushes stone down urethra 
Restless
N+V
Dysuria
Haematuria
Proteinuria
Sterile pyuria 
UTI
Oliguria
FUNI Sx
- Frequency and urgency = most common 
- Nocturia / incontinence = less common
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What suggests secondary infection and urgent RX

A

Pyrexia
Loin tenderness
Pyuria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What must you exclude

A 
RUPTURED AAA
Pulsatile mass
Pulses
BP mismatch 
CT
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are RF for developing stones

A 
Recurrent UTI 
Metabolic - hyper Ca, uric, PTH 
Urinary tract abnormality - PKD / horse shoe kidney 
Foreign body
Dehydration
High protein diet
Renal tubular acidosis
Drugs 
FH
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What drugs

A

Loop diuretic
Steroid
Theophylline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

How do you Dx renal stone

A

USS often used as quick initial test but may miss small
Non contrast CT KUB = 1st line
X-Ray KUB or IVU = less sensitive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

When do you do non-contrast CT KUB

A

Immediate if fever or 1 kidney or if uncertain over AAA

Within 14 hours otherwise

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What other investigations do you do

A

Bloods - for infection and renal function
Split renal function
Urine Dipstick - blood, exclude infection / UTI
bhCG in all women with abdominal pain
MSSU
Blood culture of other septic signs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What bloods

A 
FBC - infection 
U+E - renal function 
CRP - infection 
Coag if intervention
Calcium / albumin / urate / bicarb / glucose / PTH for underlying cause
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

If CT shows hydronephrosis what does this suggest

A

Stone is obstructing so urgent Rx needed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is analgesia of choice

A

NSAID
IM diclofenac as severe pain
Beware of CVS risk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

When do you admit

A 
If require IV analgesia
Deranged U+E
Hydronephrosis 
Complications 
Signs of infection - hypo / fever / tachy / raised WCC 
Surgical Rx required
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What are general measures with kidney stones
Analgesia Anti-emetic IV fluid Ax if infection Can send home with medical if small stone, no pain and no complications Nifedipine - CCB Tamsulosin (a-blocker)
26
What does nifedipine do
Start expulsion
27
What do you do if stone <5mm
Should pass with fluid with 24 hours
28
What do you prescribe as analgesia
Morphine Diclofenac Anti-emetic (Cyclisine)
29
What does Rx depend on
Size Site Co-morbid Renal function
30
What is 1st line
ESWL | Day Rx and non-invasive
31
When is ESWL CI
``` >2cm High BP Anti-coagulant Pregnancy Infection AAA ```
32
When would you do PCNL - percutaneous through back
``` Large stone PUJ stenosis Stricture MOrbid obese UTI Coagulopathy Fibrosis Small kidney High BP Pregnancy Staghorn EWSL resistant ```
33
When would you do utereoscopy + laser
<2cm but ESWL CI i.e. pregnancy
34
When would you do nephrectomy
Non-functioning infected kidney Large stones URGENT
35
What are indications for surgery
``` Obstruction Impending AKI Recurrent haematuria Recurrent pain and infection Loss of kidney function Occupation ```
36
What are complications of PCNL
``` Pseudoaneurysm AV fistula Ureteric injury Bowel injury Pneumothorax Sepsis MI ```
37
How do you prevent formation of calcium stones
Thiazide diuretic > loop to decrease Ca | High fluid
38
How do you prevent oxalate stones
CHolestyamine
39
How do you prevent uric acid stones
Allopurinol | Oral bicarb
40
What is the DDX of renal stone
``` Triple A Pyelonephritis Obstruction Malignncy Bowel Trauma - ureteric rupture ```
41
What makes pyelonephritis more likely
Septic | Urinary signs
42
Malignancy
More chronic
43
Ureteric rupture
Iatrogenic e.g. pelvic fracture
44
How do ureteric stones present
Bladder irritability Pain in scrotum / penis / labia Mimic appendicitis / diverticulitis
45
How do you Dx
CT = 1st line | IVU
46
How do you treat
ESWL 1st line | Uretereoscopy
47
When is ureteroscopy indicated
``` Obstruction Pain Fever Persistent haematuria Failed ESWL ```
48
Complications of ureteric stone
Infection
49
Complications of ureteroscopy
``` Perforation Haematuria Minor VUJ reflux Fever Uretral necrosis / stricture ```
50
What causes bladder stones
Usually 2 to bladder outflow obstruction
51
What are the symptoms of bladder stones
``` Suprapubic / groin pain Dysuria Strangury Frequency Haematuria UTI Sudden interruption of stream ```
52
How do you treat bladder stone
Cystolithoplaxy (endoscopic excision) | Surgery if large
53
When can you not do op
Septic
54
What can bladder stone do
Break of and obstruct catheter
55
What are unilateral causes of hydronephrosis
``` PACT Pelvic/ ureteric obstruction Aberrant renal vessel Calculi Tumour ```
56
What are bilateral causes
``` SUPER Stenosis urethra Urethral valve Prostatic enlragement Extensive bladder tumour Retroperitoneal fibrosis ```
57
How is hydronephrosis picked up
USS
58
How do you further investigate
CT
59
How do you treat
Remove obstruction e.g. catheter Nephrostomy if acute Stent / pyeloplasty if chronic
60
What is important to assess if bilateral kidney stone
U+E
61
What does a balatobale mass in abdominal suggest
Hydronephrosis
62
What is 1st line to investigate
USS to look for obstruction | Then CT for underlying cause
63
Infection
EMERGENCY
64
Why not contrast
As makes stone invisible as same colour
65
What has replaced IVU for renal stone
CT KUB
66
What needs urgent Rx with percutaneous nephrostomy or stent
Obstruction - bilateral or uni if single kidney Infection / urosepsis Intractable pain or vomit Impending AKI

Renal / Urology (16 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions