stones Flashcards

1
Q

stages

A

nucleation
aggregation
crystal growth
manifestation

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2
Q

different medical names

A

urolithiasis- general term
nephroliathiasis - kidney
urterolithiasis
cystolithiasis

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3
Q

staghorn

A

takes up the shape of the renal calyces and pelvis

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4
Q

struvite stones

A

infectious stones caused by bacteris KEB favour an alkaline environment

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5
Q

x ray negative stones

A

uric acid and xanthine stones

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6
Q

classifcation

A

simple
<5
5-10
10-20

complex
>20
and if you have any congenital anomaly

unilateral /bilaeral
inflammatory /obstructive

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7
Q

what ph indicates infectious stones

A

> 8.5 is suggestive

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8
Q

activators and inhibitors

A

activators is sulfonamides (one of there side effects )

inhibitors
magneisum
citrate

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9
Q

rf

A

BPH - especially bladder stones
lack of drinking water
congenital abnormality like horseshoe kidney , ureterocele

medullary sponge disease

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10
Q

extrinsic and intrisic factors

A

intrinsic
- congentilsa
- dehrdation
- gout

extrinsic
- climate
- career (hot places)
- mineral content of water

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11
Q

renal colic

A

wors pain ever , typically colic but can be constant

radiates to groin, labia majora , tesiticles

pstive succosio renalis

dysuria, hematuria , oligouria

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12
Q

secondary effects

A

migration
ulceration
malignancy
hydronephrosis due to obstruction
UTI - urosepsis
obstruction of the calcyces (hyrocalcinosis)

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13
Q

investigations

A

history
image - x ray , ct (gold standard) was previously IVU
ULTRASOUND- but can miss stones

ureteroscope - both diagnostic and therapeutic

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14
Q

dx

A

appendicitis if on RHS
cholecystitis
ectopic pregnancy
cystitis - especially if in lower ureter

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15
Q

bladder stones

A

usually asymptomatic
usually passed
associated with stasis of urine like in bPH

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16
Q

WHERE IS THE MSOT COMMON SITE OF OBSTRUCTION

A

THE NARROWEST PART WHICH IS THE VESICOURETERIC JUNCTION

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17
Q

WHAT makes having stones more urgent

A

a congenital anomly

only having one kidey

big size

bilateral obstruction

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18
Q

tx

A

if small can just give fluids

spasomlytics to add expuslion

pain releief - NOT OPIODS

ecswl-

ureteroscope - has theureupitcs effects can break up the stone

intracroprpreal

percutaneous nephrolithotomy- incision in flank region

19
Q

indications for ECSWL

A

stones are x ray +

> 2cm

20
Q

intracorporeal

A

uretroscope- felxible and rigid

21
Q

open surgery techniques

A

nephrolithotomy
ureterolithotmy
cystolithotomy
pyelolithotomy -pelvis

22
Q

litholipaxy

A

The removal of a vesical calculus by first crushing it and subsequently washing out the fragments.

bladder stone(s) using telescopic fragmentation devices or a laser passed through your urethra (waterpipe). Once the stone has been broken up, the small fragments produced can be removed using suction.

23
Q

vivilite ( double check)

A

ca monohydrate

24
Q

videliti ( double check )

A

ca dihydrate

25
Q

appetite (double check )

A

ca oxalate

26
Q

nephrocalcinosis

A

stones in the renal parenchyma

27
Q

why do we put in a stent with kidney stones

A
  1. helps reduce the pain of renal colic
  2. allows for drainage
  3. after surgery to allow healing process to occur as edema is a side effect
28
Q

apart from stones what can block the ureters

A

tumours
BLOOD CLOTS
STRICUTRES/STENOSIS
post op sweeling
infection-nb

29
Q

cysteine stones points

prevention

A

suffer from condition callled cysteinuria

drink more water

eat foods to make urine more BASSI=(stones form in more acidic urine) so avoid meats which make urine more acidic

reduce salt intake

ca n take certain meds that work in different ways,

30
Q

name for struvite

A

Magnesium ammonium phosphate

31
Q

different geentic conditions and how they relate to stones

A

xathinuria - runs in families

cysteinuria- runs in families

32
Q

xantheniuria facts

A

genetics, high levels of xanthine but conversely low levels of uric acid

33
Q

drug induced stones

A

sulfoanmides

ceftriazone

hIV drugs

34
Q

poor radiopaque

A

STRUVITE

35
Q

risk factors

A

diet- meat, salt
hyperparathyrodiism
chrones
FH
Inheritied codnitons

35
Q

risk factors

A

diet- meat, salt
hyperparathyrodiism
chrones
FH
Inheritied codnitons

36
Q

Anatomical abnormalities leading to stone formation:

A

pelvic ureteric junction obstruction —> PUJ obs - stenosis as a congenital anomaly
* Horseshoe kidney
* Ureterocele
*** know detailed d

37
Q

why is prgenancy a risk factor

A

stasis of urine

mechanical compression of ureters but also because hormonal changes like progesterone which relaxes peristalsis

37
Q

why is prgenancy a risk factor

A

stasis of urine

mechanical compression of ureters but also because hormonal changes like progesterone which relaxes peristalsis

38
Q

classification of stasis

A

mechanical - obstruction like ureteropelvis , stone

dynamic - pregnancy

39
Q

1st line for big stones

A

percutanoeous nephrolithotomy >1.5 cm

40
Q

calculus anuria

A

bascilaly when you have a complete obstruction in either 1 kindey(other one is non functional) or both kidneay so not only is there stasis but now kidneys are not making the urine?

41
Q

stasis vs retention

A

upper/lower urinary tract

42
Q

classifctaion of renal colic

A

uncomplicated

complicated
- prolonged course
- YOU HAVE FEVER NOW
-ANURIA