Renal Calculi: Nephrolithiasis

Question 1

Renal calculi Incidence/Causes

Answer 1

10% of the population will develop urinary calculi during their lifetime

Calcium Stones: 80 % of all stones, are frequently familial, more common in men, avg age of onset > 30

Uric Acid Stones: Most common in men, 1/2 have gout

Struvite stones: occur mainly in women, result from UTI with urease- producing bacteria, may grow to a large size and fill renal pelvis

Cystine Stones: only amino acid that becomes insoluble in urine, difficult to manage

Question 2

Nephrolithiasis signs/symptoms

Answer 2

A stone me traverse the ureter without symptoms; however, passage usually per produces pain and bleeding
Acute (colic like) blank pain is usually seen with increasing intensity
Radiation of pain downward to the grind indicates that the stone has passed to the lower third of the year order; testicular pain may also occur

Question 3

Nephrolithiasis lab/diagnostics

Answer 3

CT scan

Urine analysis, CBC, BMP

Question 4

Nephrolithiasis management

Answer 4

Depends on the stone type, location, extent of obstruction, the function of the kidneys, and the progress of the stone passage
Analgesia and hydration: initial treatment measures include a standard Iv trio: morphine or hydromorphone, Toradol, and metoclopramide
Lithotripsy may be indicated for large stones