Nephrolithiasis Flashcards
What are the S/S for urinary tract stones?
Colicky loin-groin or renal pain Hematuria - gross or micro Dysuria Restlessness N/V Fever and chills sometimes
3 most common places to get stones
Ureteropelvic junction
Ureter crossing iliac vessels
Ureter entering into bladder
Men: prostate
“Never miss” DDx for stones?
Abdominal aortic aneurysm
Study of choice for stones?
Helical CT
Why are X-Rays not as good as CTs for stones?
X-Rays won’t show uric acid stones
Most renal stones are composed of ____
Calcium oxlate, or calcium phosphate
What size stones usually pass on their own?
Less than 5 mm
What meds can you give to help someone pass stone?
Alpha Adrenergic antagonists
Ca channel blockers
Stones of what size are probably not going to pass
Over 7mm
What are some inhibitors of stone crystallization?
Citrate
Urinary glycoproteins
What are the causes of hypercalcuria?
Over-absorption, PTH issues
What is the biggest risk factor for calcium stones?
Hypercalciuria
How are struvite stones formed and what are they made of?
Caused by urease-producing bacteria that linger usually due to urinary stasis; often become large ‘staghorn’ stones
Struvite = MgNH4PO4
How do you manage struvite stones?
Remove large stones
Correct predisposing causes
GIve antibiotics
What are the risk factors for uric acid stones?
Gout; purine intake from animal protein; tumor lysis
