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ENDO-RENAL > Nephrolithiasis > Flashcards

Nephrolithiasis Flashcards

1
Q

All of the following are TRUE about kidney stones EXCEPT:

A. Calcium oxalate stones are the most common while cystine stones are the least common
B. Stones can be composed of acyclovir, atazanavir, and triamterene in rare cases
C. Stones that form as a result of lower tract infection, if not appropriately treated, may lead to ERSD
D. Selection of treatment, prevention and prognosis depends on what stone
E. None of the options

A

C. Stones that form as a result of lower tract infection, if not appropriately treated, may lead to ERSD

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2
Q

All of the following may predispose a patient to nephrolithiasis EXCEPT

A. Gastric bypass surgery
B. Primary hyperparathyroidism
C. Obesity
D. Type 1 DM
E. None of the options
A

D. Type 1 DM

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3
Q

According to renal biopsies, calcium phosphate stones are mostly found in __________

A. Renal papilla
B. Renal pyramid
C. Renal interstitium
D. Renal cortex
E. Renal medulla
A

C. Renal interstitium

Calcium oxalate = renal papilla

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4
Q

All of the following are associated with a lower risk of kidney stones EXCEPT:

A. Calcium
B. Magnesium
C. Potassium
D. Sodium
E. Two of the options
F. None of the options
A

D. Sodium

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5
Q

All of the following are TRUE about dietary risk factors EXCEPT:

A. Supplemental calcium may increase the risk of stone formation
B. Potassium-rich foods increase urinary citrate excretion due to their alkali content
C. Vitamin C supplements are associated with increased risk oxalate stone formation in women
D. Dietary oxalate is only a weak risk factor for stone formation
E. Two of the options
F. None of the options

A

C. Vitamin C supplements are associated with increased risk oxalate stone formation in women

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6
Q

All of the following are TRUE about effects of fluids and beverages on stone formation EXCEPT:

A. The risk of stone formation increases as urine volume decreases
B. When the urine output is 2L/d, the risk of stone formation more than doubles
C. Beer and wine reduces the risk of stone formation
D. Soda increases the risk of stone formation
E. None of the options

A

B. When the urine output is 2L/d, the risk of stone formation more than doubles

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7
Q

All of the following are nondietary risk factors that are associated to nephrolithiasis EXCEPT:

A. Age
B. Race
C. Body size
D. Environment
E. None of the options
A

E. None of the options

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8
Q

All of the following are TRUE about urinary risk factors of nephrolithiasis EXCEPT:

A. Levels of urine calcium reabsorption are higher in individuals with a history of nephrolithiasis
B. Higher urine oxalate excretion increases the likelihood of calcium phosphate and oxalate stones formation
C. Lower urine citrate excretion increases the risk of stone formation
D. Calcium phosphate stones are more likely to form when the urine pH is equal or more than 6.5
E. Two of the options
F. None of the options

A

E. Two of the options

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9
Q

This is an autosomal recessive disorder that causes excessive endogenous oxalate generation by the liver with consequent calcium oxalate formation.

A. Cystinuria
B. Primary hypooxaluria
C. Primary hyperoxaluria
D. Secondary hypooxaluria
E. Secondary hyperoxaluria
A

C. Primary hyperoxaluria

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10
Q

Consider a patient that experiences urinary urgency and frequency. As a physician, you would suspect stone lodging at which location?

A. Right ureteral pelvic junction
B. Right pelvic brim
C. Left pelvic brim
D. Ureterovesical junction
E. Proximal ureter
A

D. Ureterovesical junction

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11
Q

Which of the following stones is entirely radiolucent?

A. Calcium phosphate
B. Calcium oxalate
C. Uric acid
D. Cystine
E. Struvite
A

C. Uric acid

Calcium phosphate/oxalate = radiopaque
Cystine/struvite = weakly radiopaque

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12
Q

All of the following may cause struvite stones EXCEPT:

A. Proteus mirabilis
B. Klebsiella pneumoniae
C. Providencia sp.
D. Escherichia coli
E. None of the options
A

D. Escherichia coli

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13
Q

All of the following may contribute to formation of kidney stones due to its high oxalate content EXCEPT:

A. Spinach
B. Rhubarb
C. Potatoes
D. Broccoli
E. None of the options
A

D. Broccoli

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14
Q

Which of the following thiazide diuretics can reduce calcium oxalate stone recurrence by ~50%?

A. HCTZ
B. Indapamide
C. Chlorthalidone
D. Chlorothiazide
E. Metolazone
A

C. Chlorthalidone

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15
Q

What is the pH goal for patients with uric acid stones?

A. 8.0
B. 7.5
C. 6.5
D. 6.0
E. 5.5
A

C. 6.5

Cystine = 7.5

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16
Q

Which of the following stones is associated with IBD?

A. Calcium oxalate
B. Calcium phosphate
C. Uric acid
D. Cystine
E. Struvite
A

A. Calcium oxalate

17
Q

Type 1 renal tubular acidosis is more common in what patients with what type of kidney stones?

A. Calcium oxalate
B. Calcium phosphate
C. Uric acid
D. Cystine
E. Struvite
A

B. Calcium phosphate

18
Q

Gold standard diagnostic test for nephrolithiasis

A. Non-contrast MRI
B. Non-contrast CT scan
C. Contrast CT scan
D. Any of the options

A

B. Non-contrast CT scan

19
Q

Percutaneous nephrostolithotomy is indicated to patients with which of the following?

A. Small non obstructing upper tract stones
B. Large non obstructing upper and lower tract stones
C. Large obstructing upper tract stones
D. 10-20mm stone size
E. Any of the options

A

C. Large obstructing upper tract stones

20
Q

Which of the following urologic evaluation procedures is the least invasive?

A. SWL
B. Endourologic approach
C. Percutaneous nephrostolithotomy
D. Ureteroscopy
E. Any of the options
A

A. SWL

21
Q

Which of the following is considered as the first line agent in medical expulsive therapy?

A. Nifedipine
B. Allopurinol
C. Tamsulosin
D. Tiopronin

A

C. Tamsulosin

22
Q

Which of the following kidney stones is dumbbell-shaped?

A. Calcium oxalate
B. Calcium phosphate
C. Uric acid
D. Cystine
E. Struvite
A

A. Calcium oxalate

Calcium phosphate: wedge-shaped prisms
Uric acid: rhomboid
Cystine: hexagonal
Struvite: rectangular/coffin-lid

23
Q

Which of the following imaging modality has the highest sensitivity for detecting kidney stones?

A. Ultrasonography
B. Plain radiography
C. IV Pyelography
D. Non-contrast helical CT

A

D. Non-contrast helical CT

24
Q

All of the following are dietary modifications to prevent calcium oxalate stones EXCEPT:

A. Restriction of non-dairy animal protein
B. Restrict sodium intake to <5g/d
C. Minimize sucrose and fructose intake
D. Adapt DASH diet
E. None of the options
A

B. Restrict sodium intake to <5g/d

<2.5g/d

25
Q

Which of the following is TRUE about renal colic in nephrolithiasis?

A. Caused by urine supersaturation
B. Due to calcium phosphate deposits at the thin limb of loop of Henle
C. Due to erosion and inflammation of the papillary epithelium
D. Caused by dilation, stretching, and spasm due to obstruction
E. Any of the options

A

D. Caused by dilation, stretching, and spasm due to obstruction

ENDO-RENAL (4 decks)

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