Urinary tract stones/renal calculi/nephrocalcinosis Flashcards
1
Q
How common are UTI stones?
A
Common – lifetime risk of 10%
2
Q
What is the pathology of UTI stones?
A
- Most stones are made from calcium oxalate or calcium phosphate
- Uric acid, magnesium ammonium phosphate and cysteine stones also form
- Infection stones from UTI’s can occur
- Cystine stones are formed by a autosomal recessive condition affecting cysteine and dibasic amino acid transport in the kidney and GI tract
- Caused by soluble material precipitates into crystals
3
Q
What are the risk factors/aetiology of UTI stones?
A
- Male
- Low calcium diet – in the Middle East
- Dehydration
- Calcium stones:
- Hyperparathyroidism
- Excessive reabsorption of calcium due to immobilisation
- Primary renal diseases e.g. medullary sponge disease, polycystic renal disease
- Renal tubular acidosis
- Oxalate stones
- High oxalate diet e.g. spinach, tea – in the Middle East
- Chronic intestinal malabsorption
- Enzyme deficiency
- Uric stones
- Iliostomies
4
Q
What are the signs/symptoms of UTI stones?
A
- Most asymptomatic
- Loin pain – renal calculi
- Severe intermittent renal colic – ureteric stones
- Pain from loin to groin
- Radiates into scrotum/labium/tip of penis
- Nausea/vomiting
- Sweating
- Haematuria
- Fever – if infection present
- Bladder stones:
- Haematuria
- Frequency
- Urethral stones/obstruction:
- Anuria
- Painful bladder distention
5
Q
What investigations are conducted for suspected UTI stones?
A
- Mid stream sample – culture
- Bloods:
- Urea
- Electrolytes
- Creatinine
- Calcium
- X-ray
- CT
6
Q
What are the surgical treatments for UTI stones?
A
- Extracorporeal shock wave lithotripsy (ESWL)
- Ureteroscopy
- Open surgery - rare
7
Q
What are the pharmacological treatments for UTI stones?
A
- Analgesia e.g. diclofenac
* Thiazide diuretics
8
Q
What are the non pharmacological treatments for UTI stones?
A
- Fluids
- Water softer
- Treat
