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Renal Week 3 > Stones > Flashcards

Stones Flashcards

1
Q

name five diseases that are risk factors for stones

A

hyperparathyroidism
RTA
Obesity
Gout Diabetes

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2
Q

if you have recurrent stones what two things are you at risk for?

A

osteoporosis and ostiopenia

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3
Q

what are the three steps in stone formation?

A

supersaturation
nucleation
aggregation

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4
Q

what is the most common type of stone?

A

calcium oxalate

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5
Q

how does caclium oxalate appear on Xray?

A

opaque

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6
Q

how does calcium phosphate appear on Xray?

A

opaque

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7
Q

how does magnesium ammonium phosphate or struvite appear on Xray?

A

opque

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8
Q

how does uric acid stone appear on Xray?

A

lucent

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9
Q

how does cystine stone appear on Xray?

A

opaque

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10
Q

what is the usual cause of a calcium oxalate stone?

A

idiopathic hypercalcemia

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11
Q

where do nuclei commonly bind to when forming a calcium oxalate stone?

A

an area called randalls plaque

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12
Q

where is randalls plaque? why is it important?

A

in the terminal collecting duct and minor calyx…it is a spot for nucleation to occur in calcium oxalate stones…they attach and grow here until they break off

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13
Q

what two things must be high in the urine to have a calcium oxalate stone?

A

oxalate and calcium

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14
Q

what usually is cause of hyperoxaluria?

A

high dietary intake

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15
Q

does high or low uric acid lead to a risk for calcium oxalate stones?

A

high…because they block the inhibitors of stones like citrate

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16
Q

what must patients have to have a calcium phosphate stone?

A

high urine pH or basic pH

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17
Q

where do struvite or magnesium ammonium stones come from?

A

infections

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18
Q

what must an organism have to cause a struvite stone?

A

urease

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19
Q

name the three common infections leading to struvite stones, which is most common?

A

proteus..most common
staphylococcus
Klebsiella

20
Q

how do you treat a struvite stone?

A

have to remove the whole thing surgically

21
Q

what are two risks with struvite stones?

A

renal failure and sepsis

22
Q

if you eat a ton of read meat…what type of stone are you likely to have? why?

A

uric acid stone

uric acid is breakdown product of purines

23
Q

what is the rule about uric acid stones and pH of urine?

A

to have a uric acid stone the urine pH must be lower than 5.5

24
Q

name the only stone that has a genetic link? what is the genetics?

A

cystine stones

auto recess

25
Q

what can you do to treat cystine stones? why?

A

can give alkalizing agent because they become soluble at pH above 9.5

26
Q

where can stone pain refer to?

A

groin area

27
Q

how do you describe the pain in a stone?

A

acute colicky flank pain in back

28
Q

name three other symptoms you can have with a stone

A

hematuria
nausea/vomiting
frequency and urgency

29
Q

what is the most important indication for immediate intervention with a stone?

A

obstruction upper tract with infection

30
Q

how do you usually treat a kidney stone?

A

let the person pass it

31
Q

what can you tell a patient to do that will help pass a stone?

A

drink more fluid…water

32
Q

what are the five dietary changes to limit stone risk?

A 
low salt
low oxalate
low calcium
low purine intake
high citrate intake
33
Q

what is a medication you can offer to lower calcium and lower risk of recurrent stones?

A

thiazide diuretics

34
Q

what is the treatment for uric acid and cystine stones?

A

alaklination of the urine and hydration

35
Q

shape of calcium oxalate stone crystal

A

envelope or bumbbell

36
Q

shape of calcium phosphate stone crystal

A

wedge shaped prism

37
Q

shape of ammonium magnesium crystal

A

coffin lid

38
Q

what is the shape of the stone that ammonium magnesium or struvites usually make?

A

staghorm caliculi

39
Q

how must struvite stones be managed?

A

surgical intervention

40
Q

what is a suicidal med that is associated with stones? what type of stones?

A

ethylene glycol or antifreeze

calcium stones

41
Q

gout commonly leads to what type of stone?

A

uric acid stone

42
Q

name two treatment options for uric acid stones

A

allopurinol or alkanilation of urine…usually the latter

43
Q

what is the shape of the uric acid crystal in a stone?

A

rhomboid or rosettes

44
Q

what is the shape of cystine crystal in a stone?

A

hexagonal

45
Q

what age group gets cystine stones?

A

kids

Renal Week 3 (10 decks)

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