Renal Colic and Nephrolithiasis Flashcards
Gross hematuria is __ until proven otherwise
Cancer
FUND stands for
Frequency
Urgency
Nocturia
Dysuria
3 areas of narrowing in ureters
Ureteropelvic junction
Crossing iliac vessels
Ureterovesical junction
What type of stones form in
- Acidic urine
- Alkaline urine
- Uric acid crystals
2. Struvite stones
Types of calculi
Calcium oxalate (most common)
Uric acid (do not see on xray)
Struvite (form in alkaline)
Cystine (genetic)
What 3 things make up struvite stones
Magnesium
Ammonium
Phosphate
Presentation of patient with nephrolithiasis
Writhing in pain N/V CVA tenderness Unable to lay still Diaphoretic Hematuria Voiding difficulties
How to diagnose kidney stones
CT non contrast
US
Xray (not uric acid stones)
Red flag signs for nephrolithiasis
Fever Elevated WBC Solitary kidney or bilateral obstruction Renal failure Pregnancy Pain refractory to analgesia intractable N/V
What meds are used to expel stones?
Alpha-blockers (relaxes smooth muscle)
Surgical interventions for nephrolithiasis
Ureteric stenting
Extracorporeal shock wave lithotripsy
ureteroscopy and laser lithotripsy
Percutaneous nephrolithotomy
Dietary guidelines with nephrolithiasis
High fluid intake Low salt intake Decreased animal protein Normal Ca intake Increased citrate intake
