Stones

Question 1

name five diseases that are risk factors for stones

Answer 1

hyperparathyroidism
RTA
Obesity
Gout Diabetes

Question 2

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

Answer 2

osteoporosis and ostiopenia

Question 3

what are the three steps in stone formation?

Answer 3

supersaturation
nucleation
aggregation

Question 4

what is the most common type of stone?

Answer 4

calcium oxalate

Question 5

how does caclium oxalate appear on Xray?

Answer 5

opaque

Question 6

how does calcium phosphate appear on Xray?

Answer 6

opaque

Question 7

how does magnesium ammonium phosphate or struvite appear on Xray?

Answer 7

opque

Question 8

how does uric acid stone appear on Xray?

Answer 8

lucent

Question 9

how does cystine stone appear on Xray?

Answer 9

opaque

Question 10

what is the usual cause of a calcium oxalate stone?

Answer 10

idiopathic hypercalcemia

Question 11

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

Answer 11

an area called randalls plaque

Question 12

where is randalls plaque? why is it important?

Answer 12

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

Question 13

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

Answer 13

oxalate and calcium

Question 14

what usually is cause of hyperoxaluria?

Answer 14

high dietary intake

Question 15

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

Answer 15

high…because they block the inhibitors of stones like citrate

Question 16

what must patients have to have a calcium phosphate stone?

Answer 16

high urine pH or basic pH

Question 17

where do struvite or magnesium ammonium stones come from?

Answer 17

infections

Question 18

what must an organism have to cause a struvite stone?

Answer 18

urease

Question 19

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

Answer 19

proteus..most common
staphylococcus
Klebsiella

Question 20

how do you treat a struvite stone?

Answer 20

have to remove the whole thing surgically

Question 21

what are two risks with struvite stones?

Answer 21

renal failure and sepsis

Question 22

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

Answer 22

uric acid stone

uric acid is breakdown product of purines

Question 23

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

Answer 23

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

Question 24

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

Answer 24

cystine stones

auto recess

Question 25

what can you do to treat cystine stones? why?

Answer 25

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

Question 26

where can stone pain refer to?

Answer 26

groin area

Question 27

how do you describe the pain in a stone?

Answer 27

acute colicky flank pain in back

Question 28

name three other symptoms you can have with a stone

Answer 28

hematuria nausea/vomiting frequency and urgency

Question 29

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

Answer 29

obstruction upper tract with infection

Question 30

how do you usually treat a kidney stone?

Answer 30

let the person pass it

Question 31

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

Answer 31

drink more fluid...water

Question 32

what are the five dietary changes to limit stone risk?

Answer 32

``` low salt low oxalate low calcium low purine intake high citrate intake ```

Question 33

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

Answer 33

thiazide diuretics

Question 34

what is the treatment for uric acid and cystine stones?

Answer 34

alaklination of the urine and hydration

Question 35

shape of calcium oxalate stone crystal

Answer 35

envelope or bumbbell

Question 36

shape of calcium phosphate stone crystal

Answer 36

wedge shaped prism

Question 37

shape of ammonium magnesium crystal

Answer 37

coffin lid

Question 38

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

Answer 38

staghorm caliculi

Question 39

how must struvite stones be managed?

Answer 39

surgical intervention

Question 40

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

Answer 40

ethylene glycol or antifreeze | calcium stones

Question 41

gout commonly leads to what type of stone?

Answer 41

uric acid stone

Question 42

name two treatment options for uric acid stones

Answer 42

allopurinol or alkanilation of urine...usually the latter

Question 43

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

Answer 43

rhomboid or rosettes

Question 44

what is the shape of cystine crystal in a stone?

Answer 44

hexagonal

Question 45

what age group gets cystine stones?

Answer 45

kids