urological causes of abdo pain

Question 1

renal colic how much per wave

Answer 1

30mins

Question 2

kidney stones what test

Answer 2

urine dip - blood ( microscopic)
nitrites - exclude UTI

Question 3

is CT KUB with contrast

Answer 3

no - to allow visualisation with calcifed structures
you dont need contrast ultimately

Question 4

why do you face pts down with kidney stones

Answer 4

helps to aviud misdiagnosis

Question 5

worst stones are ones higher up and larger - about what will pass

Answer 5

5mm

Question 6

sned home if 2mm what else

Answer 6

bring back for CT so thats it gone 4weeks
or if any sx of ~UTI

Question 7

very large k stone what can you do

Answer 7

shock wave lithotripsey - ESWL - extracorpial shock wave litrhoripsey
PCNL - percutaneous nephro lithotomy - through skin kidney and cut
uteroscopy - URS - most common - break with laser energy

Question 8

3 reasons for stones becoming complicated

Answer 8

1. combined with a UTI - infected obstructed kidney
   - need to drain abscess
2. bad renal failure
3. pain

need to do urgent decompression - nephrostomy - tube into kidney - drain kidney through tube
ureteric stent - whole of ureter- ankored at top and bottom - JJ stent

intramural ureter goes through bladder wall - lots of alpha receptors - so theory tamulosin works if stone is at VUJ