Nephrolithiasis Flashcards
9/11/19
Presence of an initial kidney stone attack after age ___ is very rare
50
Up to 1 in ___ people will be affected by a kidney stone in their lifetime
11
All kidney stones are more common in men except for ____
struvite stones
Risk factors for nephrolithiasis (6)
- DM
- PKD
- dehydration
- cystinuria
- hyperparathyroidism
- drugs
Recurrence rate for a kidney stone is __%
52
4 types of kidney stones and a unique fact about each
1) calcium oxolate (most common)
2) struvite (more common in women and causes staghorn calculi)
3) uric acid (seen in gout)
4) cystine (related to cystinuria, autosomal recessive disease)
Staghorn calculi definition
Upper urinary tract stones that involve the renal pelvis and extend into at least 2 calyces, most often struvite type and seen in females
___ is a medication used to treat UTI’s but have to be careful because it increases risk of ____ formation
Ceftriaxone, kidney stone
What is the most common metabolic abnormality seen in formation of calcium oxylate kidney stones? How does low diet calcium cause increased stone formation?
Hypercalciuria
A lack of Ca2+ in diet to bind oxalate and neutralize it means that it is absorbed into the blood stream and urine increasing new stone formation
Clinical presentation of nephrolithiasis
Sudden onset of severe pain that starts in flank and moves inferior and anterior, often with associated nausea, vomiting, occasionally fever and chills if coexisting infections, and restlessness
Even large calculi can be ___ in patients until they are triggered to begin moving
asymptomatic
Pain from nephrolithiasis may suddenly stop for a period when…
….the stone reaches the bladder
Stranguria definition
Painful frequent urination of small volumes with associated urgency, urine expelled slow drop by drop with straining and patient is left with incomplete sense of emptying
Gold standard diagnostic choice for nephrolithiasis, what about children or pregnant patients?
Non contrast CT of abdomen and pelvis, in children or pregnant patients recommended to use renal ultrasound
supportive care for nephrolithiasis (2)
- IV hydration
- pain relief (acetaminophen)
