stones

Question 1

the development of stones in the urinary tract?

Answer 1

nephrolithiasis

Question 2

what are risk factors for developing kidney stones?

Answer 2

dehydration (most common), FHx, underlying conditions (gout, crohns, hyperparathyroid, etc), medications (loop diuretics), being male, recurrent UTI

Question 3

___________refers to the pain a/w passing a kidney stone into the ureter, with ureteral obstruction and spasm

Answer 3

renal colic

Question 4

How does a patient with renal colic present on exam?

Answer 4

sudden severe pain, may be intermittent. Location is flank radiating anteriorly to groin. n/v common. hematuria common

Question 5

How do you confirm nephrolithiasis after determining that is the most likely dx on PE?

Answer 5

plain film typically catches calcium stones (85%), CT is “gold standard” and most sensitive. IVP is great for determining degree of obstruction (used if procedure is planned). U/S used for pts who cannot have radiation.

Question 6

What are the tx options for nephrolithiasis?

Answer 6

1) analgesics
2) fluids
3) let stone pass spontaneously if <1cm
4) admit for large stones, anuria, fever
5) large stones may get lithotripsy