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Renal 2 > Nephrolithiasis > Flashcards

Nephrolithiasis Flashcards

1
Q

Are kidney stones more common in men or Women?

A

Men 5:1 occurrence

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2
Q

What part of the country has the highest incidence of kidney stones?

A

The southern part of the countryincluding Socal and Arizona

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3
Q

What are the dietary risk factors for Kidney stone Devt?

A 
Less fluids
Oxalate
Sucrose/fruc
Sodium
Vit C
Ca Supp
Animal protein
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4
Q

What are the dietary protective factors for Kidney stone Devt?

A 
MORE FLUIDS
Dietary Ca
Potassium
Mg
Phytate
Coffee
Tea 
Beer
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5
Q

How can Ca Supplements be altered in Pts with risk of Stones?

A

Take Ca supps with Meals

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6
Q

What occupations put you at risk for stones?

A

High envt heat
Chronic Dehydration
Work outside

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7
Q

What are the six factors that cause Kidney Stone Fromation?

A

1) Dec Urine Volume and inc concof stone forming substances
2) Excessive Excretion of stone forming substances
3) Anatomic Abn
4) Urine pH
5) Presence or absence of urinary inhibitors
6) Urinary Proteinators

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8
Q

What is the most common type of stone?

A

Calcium Oxalate 70%

Calcium Phos 10%

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9
Q

What are the imaging modalities for Kidney Stones?

A 
Flat Plate- inadequate
Ultrasound Kidney
IVP- esp for medullary sponge kidney
CT Helical- BEST*****
Retrograde Pyelography
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10
Q

What are the risk factors for Ca++ Based stones?

A 
Low urine Volume, High pH
Hyper-calciuria
Hyper-oxaluria
Hyper-citraturia
Hyper-uricosuria
Anatomical
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11
Q

What is Dent Disease?

A

X linked Disorder of renal tubule
Hypercalcuria
Rickets due to phos wasting
LMW proteinuria

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12
Q

What can cause Hyper-oxaluria?

A

Fat malabsorption w/ intact colon
High dietary intake
Primary Hyperoxaluria
Low dietary Ca intake

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13
Q

What are the therapies for Ca Stones associated with High oxalates?

A 
Tx underlying disease
Ca
Pyridoxine
K-Mg Citrate
UroPhos K
Oxabsorb
High fluid intake
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14
Q

What increases the risk of Struvite Stones?

A

Infection with Urea splitting organisms (Proteus Mirabilus)
Alkaline Urine- Clue
Staghorn Calculi

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15
Q

What is the Tx of Infectious Stones?

A 
Medical Therapy- Atbx, Acetohydroxamic acid
Open surgery
Perc Nephrolithotomy
Lithotripsy
Combo therapy
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16
Q

What are the causes of Uric Acid Stones?

A 
Gout 
Hyperuricemia
Chronic Diarrhea
Acidic Urine pH
Low urine Volumes
RADIO LUCENT
Can be seen on CT or US
17
Q

What causes Uric Acid Stones?

A

Excessive Urinary Uric Acid Excretion and Acidic Urine

Dietary Purine Overconsumption

18
Q

What causes Cysteine stones?

A

Inherited disorder

Dec urinary reabsorption of COAL

19
Q

What is the Treatment for Uric Acid Stones?

A

Diet mod.
Alk urine
Allopurinol
Inc Urinary Volume

20
Q

What is the Tx of Cysteine Stones?

A

Fluids
Penicillamine, Captopril
Mercapto-propionl-glycine makes cysteine more soluable

21
Q

What is the General Management of Acute stones?

A 
90% will pass
Analgesia
Strain urine
Fluids
Meds
Not passing?
-cysto/retrieval 
-ESWL
-Surgery
22
Q

What are the Complications of ESWL?

A 
Hematuria
Pain-colic
Obstruction
Dec GFR
Bleeding intrarenal/retroperitoneal
Inc risk of HTN/DM?

Renal 2 (13 decks)

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