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Renal > Nephro-urolithiasis > Flashcards

Nephro-urolithiasis Flashcards

1
Q

What are the different types of kidney stones?

A

Calcium oxalate
Calcium oxalate and phosphate
Triple phosphate (infective)
Calcium phosphate

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2
Q

What are the symptoms and signs of kidney stones?

A 
Renal pain 
Ureteric colic 
Dysuria/ haematuria/ testicular or vulval pain 
Urinary infection 
Loin tenderness 
Pyrexia
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3
Q

What are the investigations for kidney stones?

A 
Bloods (FBC, U&E, creatinine) 
Calcium, albumin, urate 
Parathormone 
Urine analysis and culture 
24 hr urine collection 
KUB 
Ultrasound 
IVU 
CT KUB
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4
Q

What are the surgical indications for kidney stones?

A

Obstruction
Recurrent gross haematuria
Recurrent pain and infection
Progressive loss of kidney function

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5
Q

What are the techniques for surgical treatment?

A

Open surgery
Endoscopic surgery
ESWL (extracorporeal shock wave lithotripsy)

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6
Q

What is the advantage of open surgery for renal stones?

A

Single procedure with the least recurrence rate

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7
Q

What are the disadvantages of open surgery for renal stones?

A

Large scar
Long hospital stay
General wound complications

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8
Q

What are the indications for open surgery for renal stones?

A

Non functioning infected kidney with large stones necessitating nephrectomy

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9
Q

What are the indications for percutaneous nephrolithotomy?

A 
Large stone burden  
Associated PUJ stenosis
Infundibular stricture 
Calyceal diverticulum 
ESWL resistant stones
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10
Q

What are the contraindications for percutaneous nephrolithotomy?

A

Uncorrected coagulopathy
Active UTI
Obesity or unusual body habitus unsuitable for X-ray tables

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11
Q

What are the complications for percutaneous nephrolithotomy?

A 
Pseudoaneurysm or AV fistula 
Pelvic tear, ureteral tear, structure or PUJ
Injury to adjacent organs 
Fever, sepsis
MI
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12
Q

What are the indications for ureteroscopy?

A 
Severe obstruction 
Uncontrollable pain 
Persistant haematuria 
Lack of progression 
Failed ESWL
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13
Q

What are the different surgeries available for ureteric stones?

A

Flexible ureteroscopes
Flexible lithoclast
Holmium laser

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14
Q

What are the complications of ureteroscopy?

A

Haematuria
Fever
Small ureteric perforation
Minor vesicle-ureteric reflux

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Renal (24 decks)

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