Urinary Tract Calculi Flashcards
what is urinary tract calculi
crystal deposition within the urinary tract
what are the types of stones
calcium oxalate- most common
struvite
urate
cysteine
what are the causes of urinary tract calculis
metabolic causes such as; hypercalciuria, hyperuricaemia, hypercystinuria and hyperoxaluria
what is the most common type of stones
calcium oxalate stones
risk factor for uric acid crystals
gout
what are the general risk factors for kidney stones
low fluid intake and structural urinary tract abnormalities
presenting symptoms of urinary tract calculi
often can be asymptomatic
severe loin and groin pain
nausea and vomitting
urinary urgency, frequency and retention
haematuria
signs of urinary tract calculi on examination
loin to lower abdominal tenderness
NO signs of peritonism
signs of systemic sepsis (fever) if there is an obstruction and infection
what is the MAIN differential to urinary tract calculi
leaking AAA
what bloods will be done? And findings?
FBC - high WCC if infected
U&Es- for renal function
calcium
urate
phosphate
other investigations
urine dipstick- haematuria present
and send urine for culture
X-ray KUB; kidney stones are usually radio-opaque
management of acute urinary tract calculi (if not infected or obstructed)
analgesia, bed rest, fluid replacement and collect urine to see if any stones have passed
what sized stones usually pass spontaneously
less than 5mm
when will the stones have to be removed
if obstructed and infected the kidney
methods of removing urinary tract calculi
urethroscopy
extracorporeal shock-wave lithotripsy
percutaneous nephrolithotomy
