Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Y3(S) - Urology > Stones > Flashcards

Stones Flashcards

1
Q

What are the 5 different types of renal stone?

A

Calcium Oxalate (most common)
Calcium phosphate
Urate stones
Cysteine stones
Magnesium ammonium phosphate/struvite stones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What condition are cysteine stones typically seen with?

A

Homocystinuria patients

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What type of stones do magnesium ammonium phhosphate/struvite stones form?

A

Stag horn calculi

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Why do struvite stones/stag horn calculi typically form and why?

A

Due to infections

The bacteria have urease enzymes which make the urine more alkaline and the struvite/magnesium ammonium phosphate forms in alkaline urine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What organism most commonly causes struvite stones?

A

Proteus mirabilis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What 2 things make urate stones different. To the other stones?

A
  1. Can be dissolved by making urine more alkaline
  2. Not visible. On plain radiographs (x-rays)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the risk factors for developing renal stones?

A

Dehydration
Male
Obese
Diet (high in meat, salt and protein)
Genetics (Homocystinuria = cysteine stones)
Old age
Bowel disease (affect absorption of calcium oxalate)
Hyperparathyroidism (calcium phosphate stones)
Cancer
CKD
Gout

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How may renal stones present?

A

Sudden severe flank pain, loin to groin/scrotum
Constant or colicky
LUTs (frequency)
Haematuria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are some differentials for a patient presenting with sudden/severe flank pain (loin to groin)?

A

AAA
Renal stones
Pyelonephritis
Bowel obstruction
Lower lobe pneumonia
MSK issue
Psoas abscess
Pancreatitis
Appendicitis
Ectopic pregnancy
Ovarian torsion.
Ovarian abscess
Biliary pathology

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What would you tend to find on examination of a patient with renal. Stones?

A

May have a temperature
Flank. Tenderness
External hernial orifices fine
External genitalia fine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What Ix would you do. With a patient with sudden severe flank pain?

A

Urine dip
Pregnancy test
FBC
LFTs
U+Es
Amylase
Serum urate + calcium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the imaging of choice for a patient with suspected renal stones?

A

CT KUB (non contrast with patient prone)

However US may be done priori

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Before any intervention, what is the management of renal stones?

A

IV fluid hydration

Analgesia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What analgesia is given for renal stones?

A

NSAIDs like Diclofenac per rectum

Morphine (oral, IM or IV)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

When do you give emergency intervention for a renal stone?

A

Infected obstructed kidney
Renal impairment
Uncontrollable pain
Singular kidney

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the 2 emergency interventions for an infected obstructed kidney?

A

Retrograde JJ stent

Percutaneous nephrostomy

17
Q

What is a retrograde JJ stent in decompressing an infected obstructed kidney?

Who inserts it?

Done under anaesthesia?

A

Urologist inserts a stent guided by cystoscopy through the urethra, bladder, ureters to the kidney

Done under general anaesthetic

18
Q

What is a Percutaneous nephrostomy in decompressing an infected obstructed kidney?

Who inserts it?

Done under anaesthesia?

A

When interventional radiologist insert a stent by puncturing through the skin straight into the renal pelvis

Its done under local anaesthetic making it good for sicker patients that cant under go GA and is a quicker procedure

19
Q

What are the 3 definitive treatments of non emergency renal stones/colic?

A

Extracorporeal shockwave lithotripsy

Percutaneous nephrolithotomy

Flexible ureteroscopy + laser lithotripsy

20
Q

What renal stones are visible on plain radiograph (X-ray)?

Which are not?

A

Visible = calcium oxalate, calcium phosphate, cysteine and struvite

Non visible = urate

21
Q

What imaging modality is used for stone surveillance if a stone is being managed conservatively?

A

Plain radiograph (stone must be radio opaque so not urate)

22
Q

What 2 non emergency treatments of stones are good for smaller stones?

A

Extracorporeal shockwave lithotripsy

Flexible ureteroscopy + laser lithotripsy

23
Q

What non emergency tretament method is best for larger stones like stag horn calculi?

A

Percutaneous nephrolithotomy

24
Q

Why is Extracorporeal shockwave lithotripsy not appropriate for larger stones?

A

Lager stones likley broken down into lots of smaller stones which can get stuck forming STEINSTRASSE

25
Q

What are the contraindications to extra corporeal shockwave lithotripsy?

A

Pregnant
Anticoagulants
Coagulopathys

26
Q

What are the complications of Extracorporeal shockwave lithotripsy?

A

SteinstraBe (inc risk with bigger stones)
Pain
Haematuria

27
Q

What are the complications of Percutaneous nephrolithotomy?

A

Infection risk (invasive + often struvite stones)

Bleed risk

28
Q

What are the complications of flexible ureteroscopy + laser lithotripsy?

A

Anaesthetic risk
Infection
Bleeding
Avusled ureter

Involved scope entering through urethra, bladder to ureters

29
Q

What are the complications of renal stones?

A

Post renal AKIs
Renal infections

30
Q

How do you manage recurrent stone formers to reduce risk of forming further stones?

A

Hydration (2-3L)
Reduce salt, meat and protein intake
Diet low in purines
Consider allopurinol to decrease urate stones
Weight loss
Exercise
Citrate (fruit drinks)
Correct calcium levels
Genetic testing (Homocystinuria?)
PTH levels testing

31
Q

What causes bladder stones?

A

Urinary stasis (chronic urinary retention)
Passed ureteric stones
Secondary too infections like schistosomiasis

32
Q

What is the management of bladder stones?

A

Men = cystoscopy

33
Q

What blood vessels pass anterior to the psoas muscles?

A

Common iliac arteries and veins

34
Q

How do you describe the location of a ureteric stone?

A

Divided into 1/3s

35
Q

What are the 1/3s of the ureter?

A

Mid ureter lies over pelvic bones

Proximal ureter above this

Distal ureter below this

36
Q

What are the 3 most common locations for stones?

A

Pelviureteric junction
Pelvic brim
Vesicoureteric junction

Y3(S) - Urology (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions