Kidney, Ureter and Bladder Stones Flashcards
what are most stones made of
calcium oxalate
which of the following is not a type of renal stone:
a. triple phosphate
b. uric acid
c. cystine
d. magnesium phosphate
e. calcium oxalate
d. magnesium phosphate
presentation of a kidney stone
unilateral flank pain renal colic (pain radiates to groin) nausea and vomiting haematuria dysuria UTI pyrexic
true/false kidney stone causes pyrexia
true
bloods investigation in a kidney stone
FBC, U&Es, creatinine, parathyroid hormone, calcium, albumin, urate
scans that can show stones
USS, X-Ray, IVU, CT
urine tests in stones
urine analysis, culture and 24 hour collection
true/false the majority of stones will pass spontaneously in 1-3 weeks
true - but 1 in 5 will not
general management of stones
NSAIDs and antiemetics
ways of surgically removing a stone
open nephrolithotomy/ureterolithotomy
percutaneous nephrolithotomy
EWSL
Ureteroscopy (to break up with a laser)
special surgical treatment for ureteric stones
JJ stent insertion
when is open surgery appropriate
when EWSL and ureteroscopy fails
major complications from a ureteroscopy
ureteric perforation
ureteral necrosis
stricure formation
what happens in a ureteroscopy
endoscope up urethra then into ureter. If the stone is small enough it is retrieved with a little basket. If it’s larger then laser to break it up
true/false a pneumothorax can result from a percutaneous nephrolithotomy
true
true/false an acute UTI contraindicated a percutaneous nephrolithotomy
true - as does obesity, uncorrected coagulopathy and nephritic fibrosis
what is the 1st line treatment for kidney stones
ESWL
what is ESWL
extracorporeal shock wave lithotripsy
complication of kidney stonesy
complete blockage causing irreversibl renal damage
pyelonephritis
kidney stones are more common in men/women
men 3:1
true/false peak incidence in men is 30 years
true
true/false peak incidence in women in 40 years old
false - bimodal at 35 and 55 years
what hormone do you check in suspected stones
parathyroid - could cause increases calcium levels and stone formation
