Urolithiasis Flashcards
1
Q
Urolithiasis Pathogenesis
A
When the urine is saturated with salt and minerals
- 60-80% contain calcium
- Randall’s plaques
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
3
Q
Urolithiasis RFs
A
Anatomical anomalies, FHx, hypertension, gout, hyperparathyroidism…
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
5
Q
Urolithiasis Differentials
A
-Biliary colic, dissection, pyelonephritis (v high temp, pain does not radiate), pancreatitis, appendicitis, perforated peptic ulcer…
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
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