Stones Flashcards
Hyperparathyroidism Renal tubular acidosis Cancers Granulomatous disease Excessive intake vitamin D Excessive intake of milk and alkali Myeloproliferative diseases
Causes
Gout
Myeloproliferative disorders
Utica acid stones
Urinary calculi Persistently alkaline, ammonia rich urine Neurogenic bladder Foreign bodies Recurrent UTI's
Struvite stones
Polycystic kidney disease Horseshoe kidneys Chronic strictures Medullary sponge disease IBS ileostomy/ bowel resection
Metabolic risk factors for stone formation
Antacids Acetazolamide Vitamin D Laxatives High doses of ASA
Medications known to cause stones
Intense deep ache in costa vertebral region Hematuria Pyuria Pain radiates anteriorly and downward toward the bladder in the female Toward testis in the male Acute pain Tenderness over costovertebral area Nausea/ vomiting
Stones in renal pelvis
Acute excruciating colicky wavelike pain, radiating down the thigh excruciating to genitalia
Little urine is passed
Blood in urine
Stones in ureter
Irritation
Associated with URI
hematuria
Urinary retention
Stones lodge in bladder
Liberal fluid intake is encouraged sling with dietary restriction of protein and sodium
Calcium stones
Low purine diet to reduce the excretion of uric acid in urine
Uric acid stones
Shellfish Anchovies Asparagus Mushrooms Organ meats
Uric acid stones
Low protein diet
Alkalized urine
Fluid intake increased
Cysteine stones
Limited intake of oxalate
Dilute urine
Oxalate stones
Spinach Strawberries Rhubarb Chocolate Tea Peanuts Wheat bran
Oxalate stones
Infection Urinary Stasis Periods of immobility Slow renal drainage Alter calcium metabolism Increased calcium concentrations Urine promote precipitation of calcium and formation
Factors favoring stone formation
Excessive intake of Calcium, salt, V-D Immobilization Hyperthyroidism Renal Acidosis Acid Ash: Meat, Eggs, Fish, Poultry Cheese, whole grain cereals, bread Prunes, Cranberry, Plum Corn, Legumes -Low sodium, low protein
Calcium Phosphate
Metabolic Error
acid ash: Avoid
Spinach, rhubarb, beets, nuts, chocolate, tea, wheat bran and strawberries
Calcium Oxalate
UTI - Proteus mirabilits Hydrolyzes urea to ammonia Staghorn stones Acid Ash: Meat, Eggs, Fish, Poultry Cheese, whole grain cereals,bread Prunes, Cranberry, Plum Corn, Legumes
Struvite
Excess uric acid from pruine Wasting Diseases Alkaline Ash: Milk, Cream, Buttermilk Vegetables (except corn/legumes) Fruit (Except cranberries, prunes, plums) Almonds, chestnuts, coconut, olives
Uric Acid
Metabolic Defect Alkaline Ash Milk, Cream, Buttermilk Vegetables (except corn/legumes) Fruit (Except cranberries, prunes, plums) Almonds, chestnuts, coconut, olives
Cystine Stones
