Clinical Skills-Nephrolithiasis Flashcards Preview

CPR II > Clinical Skills-Nephrolithiasis > Flashcards

Flashcards in Clinical Skills-Nephrolithiasis Deck (11):
1

What are risk factors for kidney stones?

Genetics, warm environment, dehydration, sedentary lifestyle and medical conditions (gout, hyperparathyroidism, hyperthyroidism, short gut, chemo, glucocorticoids)

2

What symptoms do people present with when they have stones?

Flank pain, uncomfortable, hematuria, nausea, vomiting, fever & chills (from infections)

3

What is your differential diagnosis of conditions that present with flank pain and hematuria?

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4

What lab tests can you do to determine if someone has a kidney stone?

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5

What is the most sensitive and specific test we have for kidney stones? What is the 2nd best?

1st = non-contrast-enhanced CT scan. 2nd = KUB radiograph (IVP). They will show 90% of stones as radio-opaque. 3rd = Ultrasound. Shows hydronephrosis if stone is blocking up kidney.

6

What should you see on IVP in a kidney with a kidney stone?

A white stripe of blockaded contrast dye indicating an inability to peristalsis.

7

When are you okay to give a patient pain for the kidney stone and wait for it to pass?

75% of calculi of 5mm or less pass spontaneously

8

How do you get rid of a low risk stone with medical therapy?

Alpha-1-blocker to dilate the lower ureter & prostate and normal hydration

9

When would you consider placing a stent or doing percutaneousl nephrostomy?

Patients with a fever and pain due to pyelonephritis from blockade. After the infection is resolved, you can go back in and get the stone.

10

How can you "surgically" get rid of a stone?

Ureteroscopy, Extracorporeal Shock Wave Lithotripsy (ESWL), Percutaneous Nephrolithotomy

11

How do you prevent stone formation?

2L of urine/day, low Na+ diet, low animal protein diet and a normal Ca2+ diet.