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Renal/GU > Renal Stones > Flashcards

Renal Stones Flashcards

1
Q

Where do renal stones form?

A

Collecting ducts

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2
Q

Where are renal stones classically deposited?

A

Pelviureteric junction, pelvic brim, vesicoureteric junction

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3
Q

What is the most common renal stone?

A

Calcium oxalate

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4
Q

What are some less common renal stones?

A

Uric acid, struvite, cystine

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5
Q

How do renal stones present?

A

Renal colic, restlessness, nausea and vomiting, haematuria, dysuria

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6
Q

Where is renal colic due to obstruction of the kidney?

A

Loin

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7
Q

Where is renal colic due to obstruction of the mid-ureter?

A

Pain similar to appendicitis or diverticulitis

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8
Q

Where is renal colic due to obstruction of the lower ureter?

A

Scrotum/penile tip/labia majora

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9
Q

What is a urine dipstick usually positive for?

A

Blood, leucocytes, nitrites

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10
Q

What blood tests would you do?

A

FBC, CRP, U&E

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11
Q

What is the gold standard investigation?

A

Non-contrast CT KUB

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12
Q

What imaging would you do in pregnancy?

A

USS KUB

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13
Q

What are some differential diagnoses?

A

Appendicitis, diverticulitis, ruptured AAA

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14
Q

What symptomatic relief would you start?

A

Hydration, NSAIDs/opioids

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15
Q

What stone size pass spontaneously?

A

<5mm

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16
Q

What should you start if the stone is over 5 mm or pain is not resolving?

A

Medical expulsive therapy

17
Q

What drugs help stones pass and reduce analgesia requirements?

A

Nifedipine, alpha blockers

18
Q

What other options are there if stones aren’t passing?

A

Extracorporeal shockwave lithotripsy, ureteroscopy, percutaneous nephrolithotomy

19
Q

What are indications urgent intervention is needed?

A

Intolerable pain/vomiting, signs of obstruction/infection, AKI

20
Q

What general prevention can you recommend?

A

Decrease sodium and protein intake, increased citrus fruit, adequate fluid intake

21
Q

What are risk factors for renal stones?

A

Chronic dehydration, obesity, high protein/salt diet, recurrent UTIs, hyperparathyroidism, congenital abnormalities

Renal/GU (15 decks)

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