Stones UTIs

Question 1

kidney stone risk factors

Answer 1

family hx (3x), hyperparathyroidism, RTA, diabetes, gout, dehydration

Question 2

most common kidney stone is _____ and it is usually due to _____

Answer 2

calcium oxalate stone; idiopathic hypercalciuria

Question 3

calcium phosphate stones form in ___ urine pH and are assoc with ____

Answer 3

high; UTIs

Question 4

struvite (infection) stones are associated with?

Answer 4

urease producting bacteria (like proteus) (chronic catheters, urinary diversion, obstruction)

Question 5

prevention of struvite stones

Answer 5

long-term ABX and/or urease inhibitor (makes you SICK)

Question 6

risk factors for uric acid stone

Answer 6

dehydration, gout, high protein diet

Question 7

tx of uric acid stone

Answer 7

fluid intake + urine alkalinization (bc they occur in low urine pH)

Question 8

cystine stones occur due to? and are tx with?

Answer 8

AR genetic defect in dibasic AA transport; fluid + urine alkalinization + chelating agents

Question 9

sx of kidney stone

Answer 9

acute colicky pain (CVA tenderness), LUTS, hematuria, N/V

Question 10

evaluation of suspected kidney stone

Answer 10

urinalysis + noncontrast CT scan of abdomen/pelvis

Question 11

severe stone presentation requires urgent decompression with?

Answer 11

ureteral stent or percutanous nephrostomy

Question 12

this medication can help aid passage of a kidney stone

Answer 12

alpha blocker (tamsulosin)

Question 13

basic labs that should be collected after someone has a kidney stone

Answer 13

serum calcium, uric acid, bicarb, creatinine

Question 14

dietary px of kidney stone

Answer 14

increased fluid, low salt, normal calcium, low oxalate, low purine (meat), increased citrate

Question 15

medical tx of hypercalciuria

Answer 15

thiazide diuretic

Question 16

medical tx of hyperuricemia

Answer 16

allopurinol

Question 17

medical tx of cystinuria

Answer 17

thiols (chelating agents)

Question 18

leukocyte esterase is a measure of ___ in urine, while nitrites measure ___ in urine

Answer 18

WBCs; bacteria

Question 19

majority of UTIs caused by gram ___ bacteria, especially ____

Answer 19

negative; E coli

Question 20

tx tier of uncomplicated cystitis

Answer 20

1st: nitrofurantoin x5d OR bactrim x3d, 2nd: cipro x3d, 3rd: augmentin x7d

Question 21

tx of complicated cystitis

Answer 21

urine culture! + empiric ABX 7-14d of fluoroquinolone

Question 22

ABX course for acute vs chronic bacterial prostatitis

Answer 22

1 month vs 2 months of fluoroquinolone or bactrim

Question 23

sx of pyelonephritis

Answer 23

flank pain, fever/chills, N/V, cystitis sx

Question 24

pyelo sx are atypical in?

Answer 24

elderly and diabetics

Question 25

fever should go away within ___ hours of pyelonephritis tx

Answer 25

72 (if it doesn’t, imaging needed to rule out abscess)

Question 26

tx of pyelonephritis

Answer 26

fluoroquinolone or bactrim for outpatient; fluoro or amp-gent for inpatient

Question 27

this cystitis tx should NOT be given to tx pyelonephritis

Answer 27

nitrofurantoin