Renal Colic

Question 1

What is renal colic?

Answer 1

Renal colic is intense wave-like pain caused by the passage of ureteric stones.

Question 2

What percentage of men experience renal colic in their lifetime?

Answer 2

Approximately 12% of men experience renal colic at least once in their lifetime.

Question 3

What percentage of women experience renal colic in their lifetime?

Answer 3

Approximately 6% of women experience renal colic at least once in their lifetime.

Question 4

What are the most common types of kidney stones?

Answer 4

Most kidney stones are calcium-based, including oxalate, phosphate, or mixed types.

Question 5

Name other types of kidney stones besides calcium-based ones.

Answer 5

Other types include urate, struvite, and cysteine stones.

Question 6

What factors contribute to the formation of kidney stones?

Answer 6

The formation of kidney stones is multifactorial, involving both patient-specific and environmental risk factors.

Question 7

Where do kidney stones typically form, and when do they cause pain?

Answer 7

Kidney stones typically form in the kidneys and cause pain when they move into the ureters.

Question 8

List some risk factors for developing kidney stones.

Answer 8

Risk factors include dehydration, previous stones or family history, metabolic conditions (e.g., cystinuria, hyperparathyroidism, gout), certain medications, obesity, and bowel conditions.

Question 9

What is the characteristic pain pattern of renal colic?

Answer 9

Renal colic presents as sudden, severe, colicky pain that radiates from the loin to the groin.

Question 10

What are common accompanying symptoms of renal colic?

Answer 10

Nausea and systemic symptoms such as fever and rigors, especially if there is an associated infection.

Question 11

What might severe unilateral flank pain indicate in the context of renal colic?

Answer 11

It may indicate an infected urinary system, which is a medical emergency.

Question 12

Why is an abdominal examination important in suspected renal colic?

Answer 12

To exclude other potential complications or differential diagnoses.

Question 13

What are some differential diagnoses for renal colic?

Answer 13

Differential diagnoses include ruptured abdominal aortic aneurysm (AAA), ectopic pregnancy, ovarian torsion, tubo-ovarian abscess, testicular torsion, biliary colic, cholecystitis, cholangitis, appendicitis, and diverticulitis.

Question 14

What bedside investigations are useful in assessing renal colic?

Answer 14

Vital signs assessment, urine dipstick (to check for microscopic haematuria), and urine microscopy, culture, and sensitivity (MC&S) to check for infection.

Question 15

What laboratory tests are important in the evaluation of renal colic?

Answer 15

Full blood count (FBC), urea and electrolytes (U&E), C-reactive protein (CRP), and lactate levels.

Question 16

What is the gold-standard imaging modality for diagnosing renal colic?

Answer 16

Non-contrast computed tomography of the kidneys, ureters, and bladder (CT KUB).

Question 17

Which imaging modality is preferred for pregnant patients or young individuals with suspected renal colic?

Answer 17

Ultrasound is preferred due to the avoidance of radiation exposure.

Question 18

What is the first-line analgesic treatment for renal colic?

Answer 18

Non-steroidal anti-inflammatory drugs (NSAIDs) are the first-line analgesics.

Question 19

When might surgical intervention be necessary in renal colic?

Answer 19

Surgical intervention may be required if there is obstruction with infection, intractable pain, or failure of the stone to pass spontaneously.

Question 20

What are potential complications of untreated renal colic?

Answer 20

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.

Question 21

What lifestyle modification can help prevent the recurrence of kidney stones?

Answer 21

Maintaining adequate hydration to ensure proper urine output can help prevent recurrence.

Question 22

What dietary advice is beneficial for patients with a history of calcium oxalate stones?

Answer 22

Reducing dietary oxalate intake and moderating calcium intake can be beneficial.

Question 23

Why is it important to assess for fever in a patient with renal colic?

Answer 23

The presence of fever may indicate an associated infection, which can complicate the condition.

Question 24

What is the significance of microscopic haematuria in renal colic?

Answer 24

Microscopic haematuria is often present due to irritation of the urinary tract by the stone.

Question 25

How does obesity contribute to the risk of developing kidney stones?

Answer 25

Obesity can alter the acid-base balance in urine, increasing the risk of stone formation.