renal calculi

Question 1

initial presentation of renal calculi/urolithiasis is in what decades of life?

Answer 1

third and fifth decade

Question 2

name some of the predisposing factors for renal calculi

Answer 2

high humidity
elevated temperatures
sedentary lifestyle, hypertension, carotid calcification, CV disease
High protein
salt intake
inadequate hydration

Question 3

Signs and SX of renal calculi/urolithiasis

Answer 3

sudden pain
localized to flank (w N/V)
constantly moving to find comfortable position
episodic
stone size does not corelate with severity of sx

Question 4

Findings on UA for renal calculi?

Answer 4

90% of cases have hematuria (absence of blood does NOT exclude)
pH valuable in determining cause

Question 5

RAD for renal calculi?

Answer 5

KUB radiograph
Renal ultrasound
CT

Question 6

treatment of renal calculi?

Answer 6

(force IV fluid will NOT push stone down
forced diuresis exacerbates pain
stones less than 5-6 mm pass spontaneously)

Alpha Blockers (tamsulosin)
Ibuprofen

w/ or w/o corticosteroid (prednisone)

Question 7

when is surgery indicated with renal calculi

Answer 7

showing signs of infection of obstruction

ureterscopic
extracorporeal

Question 8

ways to prevent renal calculi/urolithiasis

Answer 8

fluid intake is of greatest importance
reduced sodium intake
animal protein limited to 1g/k a day

Question 9

when should you refer renal calculi to urology?

Answer 9

sx of infection
> 4 weeks w/o passing stone
fever
persistent N/V
intolerable pain