Kidney stones Flashcards
What is the most common type of kidney stone?
Calcium oxalate (75%)
What type of stone is caused by proteus infection?
Struvite stones
What type of stone is associated with staghorn calculi?
Struvite stones
Give 3 types of stone that tend to form in acidic urine
Calcium oxalate
Urate
Cysteine
Give 2 types of stone that tend to form in alkaline urine
Struvite
Hydroxyapatite
What is the peak age range for kidney stones?
20-40 years old
What is the main risk factor for cysteine stones?
Genetic cystinuria
What is the inheritance pattern of genetic cystinuria?
Autosomal recessive
How can you distinguish intercostal nerve irritation from kidney stones?
Pain is not colicky
Pain is worsened by particular movements/pressure spots
What is the definitive investigation for kidney stones?
Non-contrast CT
Give 3 elements of conservative management for kidney stones
Diclofenac for analgesia
Antibiotics for concurrent infection
Increased fluid intake
Which antibiotics should be used to treat infection concurrent with kidney stones?
Piperacillin/tazobactam or gentamicin
What are the indications for medical/surgical intervention for kidney stones?
Stone>5mm
Refractory pain
Give 2 medications that can be used to relax the ureter in acute kidney stones
Nifedipine
Tamsulosin
Give 2 temporary surgical interventions used for acute kidney stones
Ureteric stent
Nephrostomy
Give 2 definitive surgical interventions used for acute kidney stones
Shockwave lithotripsy
Ureteroscopy with basket
Give 1 advantage of shockwave lithotripsy over ureterocopy for kidney stones
Does not require anaesthetic
Give 3 disadvantages of shockwave lithotripsy over ureterocopy for kidney stones
May require repeated treatments
Less effective in obesity
Not possible for all stone locations
What are the indications for percutaneous nephrolithotomy to remove kidney stones?
Large, multiple or complex stones
What class of drugs is used to prevent calcium stones?
Thiazide diuretics
Give 2 strategies for prevention of oxalate stones
Low oxalate intake
Pyridoxine
Give 2 strategies for prevention of urate stones
Allopurinol
Urine alkalisation with potassium citrate or sodium bicarbonate
Give 2 strategies for prevention of cysteine stones
Penicillamine (with pyridoxine)
Urine alkalisation with sodium bicarbonate