Renal Calculi Flashcards
which stones can be dissolved?
uric acid
cysteine
can you dissolve calcium stones?
Nope
renal colic where?
anywhere along loin to groin
right sided flank pain ddx?
ovarian cyst renal colic testicular torsion renal stone appendicitis
physical signs its renal colic?
not tender on palpation
pain from loin/groin
location of pain for renal colic?
location of pain doesn’t tell you where stone is
CT KUB is?
Kidneys
ureters
bladder
CT for renal colic use contrast?
Non contrast because contrast and stones are both bright
difference between KUB abdo and abdo x-ray?
KUB gets the ureteric entrance to the bladder
why do plain abdo film in renal coli?
see if it’s radio-opaque (90%)
what is a phlebolith?
calcification in vein valve in pelvis
Initial management of renal colic?
morphine 10mg
metaclopramide 10mg
morphine alternative if allergy?
100mg pethidine
anti- emetics
chloproperazine
metaclopramide
ondansetron
alpha-blocker for renal coli
tamsulosin
extra pain relief for renal colic?
endocet suppositories
who needs treatment immediately for renal calculi?
- ppl who have single kidney only (calculus anuria)
- febrile: urosepsis
- someone who’s not responding to pain relief
where are the 3 thirds of ureter called?
upper third: lumbar
mid: SI joint
lower: pelvic ureter
what to do on follow up?
How is pain?
take KUB x-ray or
CT KUB
how long to give to pass their stone?
2-3 weeks
lithotripsy used where?
bigger stone in kidney
what to do for a very large stone in kidney?
percutaneous nephro PCNL
what size of stones will pass?
JJ stent for?
keep the ureter open to let it heal
pH of someone’s urine with uric acid stones?
5
someone with struvite, calcium stones urine pH??
7.5-8
calcium oxalate stones like to form in what kind of pH?
pH independent
how to dissolve uric acid stones?
increase the urine pH via:
- bicarb
- water to flush
- allopurinol
how to dissolve cystine stones
fluids
alkanizers
-D-peniccilamine
how much water to drink is kidney stones?
look at the colour in the urine until it;s clar
what’s the most useful biochem invesitagition fro calculi
stone analysis.
dietary calcium vs. stones in Men?
more calcium actually less stones
isolated calciuria matter?
nope
Types of stones
Cysteine: Kids
Uric Acid
Calcium
