Urolithiasis Flashcards

1
Q

Urolithiasis Pathogenesis

A

When the urine is saturated with salt and minerals

  • 60-80% contain calcium
  • Randall’s plaques
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Urolithiasis Epidemiology

A
  • Renal stones present occur in 1/10 of the population, mostly asymptomatic
  • Male:Female 3:1
  • Peak between 30 and 50
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Urolithiasis RFs

A

Anatomical anomalies, FHx, hypertension, gout, hyperparathyroidism…

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Urolithiasis Presentation

A
  • Many asymptomatic
  • Sudden severe pain causes by dilation stretching and spasm or ureter
  • Pain starts in loin at costovertebral angle and moves to groin
  • Periods of relief unlike intermittent pain of biliary or intestinal colic
  • Rigors, fever, dysuria, haematuria, urinary retention, N/V
  • Writhing in agony unlike peritonism where they lie still
  • Pyrexia suggest infection
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Urolithiasis Differentials

A

-Biliary colic, dissection, pyelonephritis (v high temp, pain does not radiate), pancreatitis, appendicitis, perforated peptic ulcer…

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Urolithiasis Ix

A

-Sticj testing for red cells (urolithiasis), white cells and nitrites (infection) and pH (pH above 7 suggests urea-splitting organisms while pH below 5 suggests uric acid stones), culture
-Bloods
-Non enhanced CT scanning
AXR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Urolithiasis Management

A

Inpatient or Outpatient

  • Outpatient if pain is relieved, patient can drink large volumes of fluid, no complications
  • NSAIDS more effective then opioids
  • Antiemetics and rehydration therapy if needed
  • Majority of stones may pass spontaneously
How well did you know this?
1
Not at all
2
3
4
5
Perfectly