Kidney stones with step2 Flashcards
What stones form in acidic urine?
Uric acid and cystine stones.
What stones form in alkaline urine?
Calcium oxalate stones. + calcium phosphate.
Ammoniummagnesium phosphate
Most common stones in kidney?
Calcium oxalate.
Calcium oxalate stones can result from …….
Idiopatic hypercalciuria. Ethylene glycol (antifreeze) ingestion, vit. C abuse, hypocitraturia, fat malabsorbtion (Crohn disease, bowel resection).
What kidney stones are seen in Crohn disease?
Calcium oxalate.
What is mechanism of stones formation in Crohn disease?
Fat malabsorbtion –> fat binds calcium and oxalate is left free to be absorbed and deposited in kidney.
What diuretic is used to treat calcium stones?
Thiazides.
Ammonium magnesium phosphate stones type? Where are founded?
Staghorn calculi in renal calyces.
Ammonium magnesium phosphate stones formed in what pH?
Alkaline.
What causes ammonium magnesium phosphate stones? Pathophysiologic mechanism?
Infections. Urease positive m/o –> hydrolyze urea to ammonia –> urine alkalinization.
What are urease positive m/o?
Proteus mirabilis, Proteus vulgaris, Klebsiella, Staph. saprophyticus.
Staghorn calculi act as nidus for ……..
Urinary tract infections.
What is a treatment of ammonium magnesium phosphate stones? (2 ones).
Surgical removal, eradication of pathogen. (antibiotics alone are not enought)
Uric acid stones formed in ……… urine pH.
Low/acidic.
What stones are most common in gout?
Uric acid stones.
What state in leukemia/myeloproliferative diseases causes uric acid stones?
Hyperuricemia.
Uric acid stones 3 causes?
- Hot, arid climate, 2. Low urine volume, 3. Acidic pH.
Most common type of stones due to low urine volume?
Uric acid stones.
How to treat uric acid stones?
Hydration, alkalinization of urine, allopurinol for gout.
How is alkalinizated urine?
With potassium bicarbonate.
What stones are radiolucent?
Uric acid stones.
What stones are radiopaque?
Calcium oxalate/phosphate, ammonium magnesium phosphate, cystine (faintly radiopaque).
Cystine stones are formed in …… urine pH.
Low/acidic.
What stones formation is due to genetic defect?
Cystine.
What is mechanism of cystine stone formation?
Decreased reabsorbtion of cystine in PCT –> cystinuria –> cystine is poor soluble –> stones form in urine.
In what age mostly occurs cystine stones?
Childhood.
What other molecules are poorly absorbed due to cysteine transport defect in PCT?
Ornithine, Lysine, Arginine.
Staghorn calculi is formed from ….
Ammonium magnesium phosphate. Cystine (may be formed, e.i. not always)
What is treatment (3 ones) of cystine stones ?
Low sodium diet, alkalinization of urine, hydration.
Urine crystals in calcium oxalate stones?
Envelope or dumbell shaped.
Urine crystals in calcium phosphate stones?
Wedge shaped prism.
Urine crystals in ammonium magnesium phosphate stones?
Coffin lid.
Stoghorn
Urine crystals in uric acid stones?
Rhomboid or rosettes.
Urine crystals in cystine stones?
Hexagonal.
Envelope shaped urine crystals are seen in ……..
Calcium oxalate.
Wedge shaped prism urine crystals are seen in ……..
Calcium phosphate.
Coffin lid urine crystals are seen in ……..
Ammonium magnesium phosphate stones.
Rhomboid or rosettes urine crystals are seen in ……..
Uric acid stones.
Hexagonal urine crystals are seen in ……..
Cystine stones.
hypercalcemia -> hypercalciuria –> think about what stones?
calcium oxalate/calcium phosphate
Crohn disease - what stones?
calcium oxalate/calcium phosphate
calcium oxalate/calcium phosphate - treatment?
hydrochlorotiazide (calcium-sparing diuretic
staghorn stone -> think about what 2 types?
clasically - amonium magnesium phosphate
also, may be in cystine stones
most common type in adults?
calcium oxalate/calcium phosphate
second mos common?
amonium magnesium phosphate
third most common?
uric acid
in children?
cystine
genetic defect - what stone?
cystine
COLA - stone?
cystine