Treatment

Question 1

What are renal calculi

Answer 1

Stones that form within the renal tract

Most stones are made from calcium (radiopaque), but others are made from strucite and uric acid crystals

Question 2

Conservative treatment of renal calculi

Answer 2

Prevent causes e.g. low calcium diet

Education about risk factors

Question 3

Surgical treatment of renal calculi

Answer 3

Anterograde or retrograde removal of large stones or staghorn calculus
Extracorporeal shcok wave lithotripsy (ESWL) for the treatment of larger stones (>0.5cm)

Question 4

Radiological treatment of renal calculi

Answer 4

Nephrostomy insertion

Antegrade ureteric stent insertion

Question 5

Medical treatment of renal calculi - what symptoms need to be treated

Answer 5

Pain
Dehydration
Nausea/vomiting
High calcium
High Oxalate
High uric acid

Question 6

Medical treatment of renal calculi - treatment of each symptom:
Pain
Dehydration
Nausea/vomiting
High calcium
High Oxalate
High uric acid

Answer 6

Pain - analgesia and tamsulosin
Dehydration - IV and oral fluids
Nausea/vomiting - Antiemetics
High calcium - Low calcium diet and stop thiazide diuretics if possible
High Oxalate - low oxalate diet
High uric acid - allopurinol

Question 7

Conservative treatment of UTI

Answer 7

Education about the condition and avoidance of predisposing risk factors

Question 8

Medical treatment of UTI

Answer 8

Trimethoprim twice daily

Consider prophylactic antibiotics if UTI is recurrent

Question 9

Treatment of recurrent UTI

Answer 9

Recurrent UTI = >4 UTIs per year

Seek to exclude anatomical variant or abnormally of the renal tract