Renal: Cases Flashcards
Pt. presents w/
sharp, stabbing pain
radiates L flank to L groin
+ Dysurea, Dark Urine, Nausea
Nephrolithiasis
Are uric acid stones found on x-ray?
no, radiolucent
3 indicated imaging for nephrolithiasis…
Non-contrast, low radiation CT > US > X-ray
What two labs may be useful in nephrolithiasis?
stone composition and UA
Which medication can facilitate stone passage?
tamulosin 0.4 mg qd
stones ___ or less in size pass spontaneously
5 mm
The below indicate the need for what intervention?
stone 10+ mm
failure to pass w/ conservative mgmt
significant obstruction
urology referral
The below indicate the need for what intervention?
urologic infx AKI anuria unyielding pain N/V
urgent urology referral
What percent of kidney stones require surgical removal?
10-20%
What is the treatment of choice for larger stones? (2+ cm)
PNL
What is the treatment of choice for distal stones?
ureteroscopy
What is the surgical tx of choice for smaller stones?
shock wave lithotripsy
consider this medication in nephrolithiasis and gout
allopurinol
Consider this diuretic to stimulate calcium reabsorption in the kidney…
hydrochlorothiazide
Perinphritic stranding on CT indicates…
inflammation/obstruction
