Renal Colic Flashcards
What is renal colic?
Renal colic is intense wave-like pain caused by the passage of ureteric stones.
What percentage of men experience renal colic in their lifetime?
Approximately 12% of men experience renal colic at least once in their lifetime.
What percentage of women experience renal colic in their lifetime?
Approximately 6% of women experience renal colic at least once in their lifetime.
What are the most common types of kidney stones?
Most kidney stones are calcium-based, including oxalate, phosphate, or mixed types.
Name other types of kidney stones besides calcium-based ones.
Other types include urate, struvite, and cysteine stones.
What factors contribute to the formation of kidney stones?
The formation of kidney stones is multifactorial, involving both patient-specific and environmental risk factors.
Where do kidney stones typically form, and when do they cause pain?
Kidney stones typically form in the kidneys and cause pain when they move into the ureters.
List some risk factors for developing kidney stones.
Risk factors include dehydration, previous stones or family history, metabolic conditions (e.g., cystinuria, hyperparathyroidism, gout), certain medications, obesity, and bowel conditions.
What is the characteristic pain pattern of renal colic?
Renal colic presents as sudden, severe, colicky pain that radiates from the loin to the groin.
What are common accompanying symptoms of renal colic?
Nausea and systemic symptoms such as fever and rigors, especially if there is an associated infection.
What might severe unilateral flank pain indicate in the context of renal colic?
It may indicate an infected urinary system, which is a medical emergency.
Why is an abdominal examination important in suspected renal colic?
To exclude other potential complications or differential diagnoses.
What are some differential diagnoses for renal colic?
Differential diagnoses include ruptured abdominal aortic aneurysm (AAA), ectopic pregnancy, ovarian torsion, tubo-ovarian abscess, testicular torsion, biliary colic, cholecystitis, cholangitis, appendicitis, and diverticulitis.
What bedside investigations are useful in assessing renal colic?
Vital signs assessment, urine dipstick (to check for microscopic haematuria), and urine microscopy, culture, and sensitivity (MC&S) to check for infection.
What laboratory tests are important in the evaluation of renal colic?
Full blood count (FBC), urea and electrolytes (U&E), C-reactive protein (CRP), and lactate levels.
What is the gold-standard imaging modality for diagnosing renal colic?
Non-contrast computed tomography of the kidneys, ureters, and bladder (CT KUB).
Which imaging modality is preferred for pregnant patients or young individuals with suspected renal colic?
Ultrasound is preferred due to the avoidance of radiation exposure.
What is the first-line analgesic treatment for renal colic?
Non-steroidal anti-inflammatory drugs (NSAIDs) are the first-line analgesics.
When might surgical intervention be necessary in renal colic?
Surgical intervention may be required if there is obstruction with infection, intractable pain, or failure of the stone to pass spontaneously.
What are potential complications of untreated renal colic?
Complications include obstruction leading to hydronephrosis, acute kidney injury, superimposed infection causing sepsis, and bilateral obstruction or obstruction in a single functioning kidney requiring emergency intervention.
What lifestyle modification can help prevent the recurrence of kidney stones?
Maintaining adequate hydration to ensure proper urine output can help prevent recurrence.
What dietary advice is beneficial for patients with a history of calcium oxalate stones?
Reducing dietary oxalate intake and moderating calcium intake can be beneficial.
Why is it important to assess for fever in a patient with renal colic?
The presence of fever may indicate an associated infection, which can complicate the condition.
What is the significance of microscopic haematuria in renal colic?
Microscopic haematuria is often present due to irritation of the urinary tract by the stone.
How does obesity contribute to the risk of developing kidney stones?
Obesity can alter the acid-base balance in urine, increasing the risk of stone formation.
