stones Flashcards
most common renal stone
calcium oxalate
gold standard Ix for stones
non contrast CT KUB
presentation of a stone
pain!! colick, loin to groin, haematuria
prevention of a stone
increase fluid, can add lemon to water, avoid carbonated drinks and potassium citrate can be used if calcium is the problem
IX of stones
urine dip, FBC/CRP/U+E (exclude concurrent infection which is an emergency), US if pregnant then non contrast CT KUB
Medical Mx of stones
Analgesia (IM diclofenac is best), alpha blocker (SM relaxation of the ureter which makes stones easier to pass - this is only done if stones <1cm)
under what size can a stone normally pass
<5mm
when would a stone <5mm need Tx
ureteric obstruction, renal development abnormality (horseshoe kidney) and previous transplant
different surgical Tx options
1) ESWL 2) ureteroscopy (used in pregnancy) 3) percutaneous nephrolithotomy
which are the only radiopaque stones
urate acid
what are staghorn stones made of
struvite (formed by bacteria - proteus mirabilis)
Rf for stones
dehydrations, high calcium, low urine output
whats the normal location of stones
PUJ, crossing the pelvic brim and VUJ
reasons to admit someone for a stone
post obstructive AKI, uncontrollable pain, evidence of infection, bilateral, horseshoe kidney
what follow up is needed if a stone is managed conservatively
imaging in 4 weeks
