Urinary tract Calculi Flashcards
Define Urinary tract calculi
Stones forming in renal area due to accumulation of crystalloid and organic matrix
size categories-<5mm, 5-20mm, staghorn-
Aetiology and risk factors of Urinary tract calculi
Crystals forms in loop of hence-usually due to high calcium
rarely-uric stones
can cause renal damage
can be caused by metabolic problems-Hyperparathyroidism, gout, cysteinuria), or underlying anatomical problem
risk: Dehydration High salt intake White Age Older Male Obesity
Epidiemology of Urinary tract calculi
Lifetime prevalence of 10%
1% of hospital admission
Signs and Sx Urinary tract calculi
Loin to groin pain, sharp
Comes in waves (short)
Go to toilet normally
heamatouria-only 85%
abode should be TOTALLY fine-if tender, think of other causes
Soft abdominal
Investigations of Urinary tract calculi
Dipstick-blood and nothing else CALCIUM/URIC acid test Pregnancy test (in case) send to AECU for CTKUB AXR-often visible if calcium
fevers of infections would be worrying
Management Urinary tract calculi
Make sure nothing weird
pain-give NSAIDS or occasionally IV paracetamol/morphine
antiemetics
prompt treatment is important-reduce damage
MET-medical expulsive therapy with alpha blocker
Uric stones can be disolved with citrate smthing
High fluid intake, and A%e esp for pyrxeria/obstruction/dehydration
Shock wave lithotripsy
Uteroscopy
Percutaneous-nephroticlithiotomy
ANYFORM OF OBSTRUCTION OR INFECTION-A&E
safety net: If fever-A&E, if she’s not passing urine, if she feels dehydrated/can’t take water down
Complications of Urinary tract calculi
Kidney obstruction-
AKI from post renal obstruction (Care if 1 kidney, or bilateral stones)-> A&E
shouldn’t get dehydrated because other kidney
Infections
Prognosis of Urinary tract calculi
Lifelong disease, with 50% rate of recurrence
but not life threatening
