Urinary tract calculi Flashcards
define urinary tract calculi?
crystal deposition within the urinary tract. Also known as nephrolithiasis.
what are the types of stones that might deposit?
Calcium oxalate Cystine Uric acid Calcium phosphate Struvite
which stone is associated with staghorn calculi?
- struvite
which is the most common stone?
- calcium oxate
causes of renal stones?
o Hypercalciuria (high calcium) o Hyperuricaemia (high uric acid) o Hyper cystinuria (high cysteine) o Hyperoxaluria (high oxalic acid) o Indinavir (antiviral) o Low fluid intake o Structural urinary tract abnormalities (
epidemiology of renal stones?
- common
- males
- 20 yrs to 50 yrs
presenting complaint of renal stones?
- SEVERE colicky loin to groin pain (writhing pain)
- N and V
- Urinary urgency, frequency, or retention
- Haematuria
recognize the signs of renal stones on examination?
- Loin to lower abdominal tenderness
- NO signs of peritonism
- any signs of sepsis
what are the investigations for renal stones?
- Non contrast CT KUB is gold standard
- Bloods
- urine dipstick
- non contrast x-ray KUB
- Intravenous Urography (IVU)
- USS
- non enhanced spiral CT
- isotope radiograph
the management plan for small urinary tract calculi?
- diclofenac IM
- bed rest
- fluid replacement
- if the stone is less than 5 it will pass through by itself
what is the management for an obstructed infected kidney?
- this is an emergency
- should be treated with renal decompression and IV antibiotics
when is urethroscopy used?
stone less than 2cm in pregnancy females
when is lithotripsy used?
stone less than 2cm in normal people
when is Percutaneous Nephrolithotomy used?
in complex very large stones
general advice to prevent stones?
- drink more water
- eat less meat and salt
