stones, insipidus, hydronephresis Flashcards
most common type of renal stones
calcium oxalate
radiology appearance calcium oxalate stones
opaque (bright)
cause uric acid stones
malignancy, children
radiology appearance uric acid stones
radiolucent (less dense)
cause calcium phosphate renal stones
renal tubular acidosis
radiology appearance calcium phosphate stones
VV radio opaque (bright)- like bones
what are struvite stones formed of
mc, ammonium, phosphate
what causes struvite stones
bacteria, chronic infection, alkaline urine
radiology appearance struvite
slightly opaque
renal stones with acidic urine
uric acid (maybe calium phosphate)
stones with alkaline urine pH
struvate
stones with normal urine pH
cystine, calcium (variable)
RF renal stones
dehydrated // raised Ca + parathyroid // renal tubular acidosis // PKD, medullary sponge
RF urate stones
gout, iliostomy
drugs that cause calcium stones
loops, steroids, azetazolamide, theophylinne
drugs that prevent calcium stones
thiazides
mx mild pain renal colic
NSAIDs - diclofenac
mx sevre pain kidney stones eg admitted
IM diclofenac
inital nvx renal stones
dipstick + culture // U+Es // FBX // calcium + urate
imaging renal stones
non contrast CT KUB within 14 hours // (USS OK as well)
mx renal stones <5mm
pass themselves within 4 weeks
what surgical emergency can occur with kidney stones + how is it mx
infection + obstruction –> decompression
mx stones surgically
shock wave (<2cm) // uteroscopy (pregnant) // pc nephrolithotomy (obstruction)
mx prophylaxis hypercalcaemia –> stones
increase fluids // low animal produce + Na // thiazides
mx prophylaxis oxalate stones
cholestramine (or pyridoxone)
prophylactic mx uric acid stones
allopurinol // urinaly alkaline eg oral bicarb
what is stag horn calculi
involve renal pelvis and extend to 2 calyces
what is assoc with staghorn calciuli
struvite + proteus infection
what is the issue in cranial diabetes insipidus
low ADH
what is the issue in nepropgenic diabetes insipidus
insensivite receptors to ADH
causes cranial diabetes insipidus
head trauma // pituitary surgery // sarcoid // haemachromatosis!!!
causes nephrogenic diabetes insipidus
genetic (ADH receptors or aquaporin channels) // high ca // low K // lithium // obstruction, sickle cell, infection
how does litium cause diabetes insipidus
desensitives kidney to ADH in collecting ducts
symptoms diabetes insipidus
polyuria and polydipsia
invx DI
high plasma oslolality and low urine osmolarity // water deprivation test (still pee lots of dilute urine)
what urine osmolality excludes diabetes insipidus
> 700
mx nephrogenic diabetes insipidus
thiazides // low salt and protein
mx central diabetes insipidus
desmopression (ADH)
what is hydropnephrosis
build up of urine –> stretched and increased pressure
cause of unilateral Hydronephrosis
PACT: pelvic uteric obstruction // aberrant renal vessels // calculi // tumours
causes bilateral Hydronephrosis
SUPER // stenosis of urethra // urtheral valve // prostate // extensive bladder tumour // retro-peritoneal fibrosis
invx Hydronephrosis
1 = USS // IVU // CT if suspected stones
