renal stones Flashcards
what are the different theories explaining the pathogenesis of renal stones ?
crystallization theory
Matrix theory
lack of Inhibitor theory
what are the inhibitors of stone formation ?
citrate
magnesium
zinc
pyrophosphate
what are the inhibitors of aggreagation in stone formation ?
Glycoaminoglycans
tomm horsfall proteins
Tamm-horsfall proteins
what are the promoters of stone formation ?
UTI
anatomical abnormalities
prolonged immobilisation
high levels of uric acid
lack of inhibitors
what are the types of renal stones ?
80% calcium stone
10% struvite stones
10% uric acid stones
what type of stones are specifically associated with UTIs ?
mgg ammonium phosphate stones
what is the presentation nof acute renal colics ?
1- sharp, spasmodic flank pain that is referred to the genitalia ( loin to groin )
2- nausea, vomiting
3- Microhematuria
4- acute ureteric obstruction
what is the presentation of chronic renal colics ?
little or no pain n
associated infection
may be associated with renal impairment
what is the gold standard for the diagnosis of renal stones ?
non contrast CT KUB
what are the Differential diagnosis of renal colics ?
pyelonephritis testicular torsion acute appendicitis diverticulitis ruptured ovarian cyst ectopic pregnancy
what is the treatment for an acute episode of renal colic ?
analgesia and alpha blockers
ureteric stent by nephrostomy
what are the elective options for renal stones ?
surveillance
MET ( medical expulsion therapy )
SWL ( shock wave lithotripsy )
endoscopic
Open
how can renal stones be prevented ?
adequate fluid intake citrate rich juice low sodium diet normal calcium intake optimize protein intake fibre lifestyle changes
