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CRRAB II Week 1 - WLB > Nephrolithiasis - Pathoma > Flashcards

Nephrolithiasis - Pathoma Flashcards

1
Q

What is nephrolithiasis?

A

Precipitation of a urinary solute as a stone.

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2
Q

What are the risk factors for nephrolithiasis?

A
  • high concentration of solute in urinary filtrate

- low urine volume (results in increased [solute])

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3
Q

What is the most common type of stone seen in adults?

A

Calcium oxalate and/or calcium phosphate

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4
Q

What very important condition do you have to exclude in patients with calcium oxalate and/or calcium phosphate stones?

A

Hypercalcemia!

-high calcium in urine may come from high calcium in the blood

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5
Q

What is the most common cause of calcium oxalate and/or calcium phosphate stones?

A

Idiopathic hypercalciuria

  • put excess calcium in urine
  • normal serum calcium
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6
Q

What type of stone is seen in a patient with Crohn’s Disease? Why?

A

Calcium oxalate.

-small bowel damage causes increased reabsorption of oxalate => binds calcium => calcium oxalate stone!

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7
Q

What is the treatment for a calcium oxalate and/or calcium phosphate stone?

A

Hydrochlorothiazide = calcium-sparing diuretic

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8
Q

What is the second most common type of stone seen in adults?

A

Ammonium Magnesium Phosphate (AMP)

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9
Q

What causes an Ammonium Magnesium Phosphate (AMP) stone?

A

Most commonly: infection cause by urease-positive organisms

  • Proteus vulgaris or Klebsiella
  • alkaline urine leads to formation of stone
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10
Q

What do Ammonium Magnesium Phosphate (AMP) stones result in?

A

-Staghorn calculi in renal calyces => act as site of origin for UTI

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11
Q

How you treat Ammonium Magnesium Phosphate (AMP) stones?

A
  • REQUIRES surgical removal of stone (due to size)

- Eradication of pathogen to prevent recurrence

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12
Q

What is the third most common type of stone seen in adults?

A

Uric acid (5%)

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13
Q

What is unique about a Uric Acid stone which complicates diagnostic imaging?

A

Radiolucent = not visible on x-ray!

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14
Q

What are the risk factors for a Uric Acid stone?

A
  • hot, arid climates
  • low urine volume
  • acidic pH
  • pts with gout
  • hyperuricemia (in leukemia or myeloproliferative disorders)
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15
Q

What is the treatment for a Uric Acid stone?

A
  • Hydration
  • Alkalinization of urine (KHC03)
  • Allopurinal for gout
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16
Q

What type of stone is most commonly seen in children and is overall a rare cause of nephrolithiasis?

A

Cystine

17
Q

What condition is associated with Cystine stones?

A

Cystinuria:

-a genetic defect of tubules that results in decreased reabsorption of cysteine

18
Q

What is the treatment for Cystine stones?

A
  • Hydration

- Alkalinization of urine

19
Q

What does a staghorn calculi in a child indicate?

A

Cystine stone

20
Q

What does a staghorn calculi in an adult indicate?

A

Ammonium magnesium phosphate stone

CRRAB II Week 1 - WLB (6 decks)

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