Paulson - Nephrolithiasis Case Flashcards

1
Q

possible presentation of nephrolithiasis (3)

A

sudden, intense, episodic pain

n/v

hematuria

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2
Q

PE finding of nephrolithiasis

A

CVA tenderness

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3
Q

preferred imaging for nephrolithiasis

A

CT A/P w.o contrast

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4
Q

CT findings of nephrolithiasis

A

hydronephrosis

stone

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5
Q

2nd line imaging for nephrolithiasis

A

US of kidneys/bladder

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6
Q

2 meds for nephrolithiasis pain

A

NSAIDs

opioids

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7
Q

med that is used in ED for nephrolithiasis

A

toradol

relieves pain w.in 10-30 min

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8
Q

3 indications for opioids in nephrolithiasis

A

NSAID contraindication

severe renal dz

unresponsive to NSAID

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9
Q

passage of stone depends on

A

size

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10
Q

stones __ mm or less usually pass spontaneously

A

5

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11
Q

stones __ mm or larger probably won’t pass spontaneously

A

10

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12
Q

indication for medical expulsive therapy

A

stones btw 5-10 mm

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13
Q

1st line med for medical expulsive therapy

A

tamsulosin (flomax) up to 4 weeks

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14
Q

besides tamsulosin (flomax), 2 other meds that can be used for medical expulsive therapy

A

CCB → nifedepine

PDE5 inhibitor → tadalafil

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15
Q

3 indications for admit for nephrolithiasis

A

PO intolerance

uncontrollable pain

fever

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16
Q

6 indications for urology consult for nephrolithiasis

A

UTI

AKI

anuria

persistent/unyielding pain or n/v

stone does not pass x 4 weeks

stone > 10 mm

17
Q

pt ed for outpt management of nephrolithiasis

A

strain urine for stone analysis

18
Q

4 types of stone

A

calcium oxalate

calcium phosphate

uric acid

struvite

19
Q

mc type of stone

A

calcium oxalate

20
Q

how do struvite stones form

A

only in presence of urease producing bacteria

21
Q

4 urease-producing bacteria

A

proteus mirabilis

klebsiella pneumoniae

corynebacterium species

ureaplasma ureaylticum