Kidney stones

Question 1

pH > 7?2

Answer 1

Calcium oxalate and magnesium ammonium phosphate (struvite or triple phosphate)

Question 2

pH < 7?2

Answer 2

Uric acid and cytine

Question 3

Most frequent stone?

Answer 3

Calcium oxalate (in patient with hypercalciuria and normocalcemia

Question 4

Highest radiograph opacity?

RADIOPAQUE

Answer 4

Calcium oxalate and calcium phosphate

Question 5

Moderate radiograph opacity? RADIOPAQUE

Answer 5

magnesium ammonium phosphate (struvite or triple phosphate) and Cystine (cystine faintly radiopaque)

Question 6

No radiograph opacity? RADIOLUCENT

Answer 6

Uric acid

Question 7

Microscopic. Octahedron (square with X in the center)

Answer 7

Calcium oxalate

Question 8

Microscopic. Rectangular prism (coffin lids)

Answer 8

magnesium ammonium phosphate (struvite or triple phosphate)

Question 9

Microscopic. Yellow or red-brown diamond or rhombus

Answer 9

Uric acid

Question 10

Microscopic. Flat, yellow, hexagonal

Answer 10

Cytine

Question 11

Microscopic. Elongated, wedge-shaped; forms rossettes

Answer 11

Calcium phosphate

Question 12

Calcium oxalate pH?

Answer 12

hypocitraturia

Question 13

Cytine pH?

Answer 13

pH<7

Question 14

Uric acid pH?

Answer 14

pH<7

Question 15

Calcium phosphate pH?

Answer 15

pH>7

Question 16

Magnesium ammonium phosphate (struvite) pH?

Answer 16

pH>7

Question 17

In hypercalciuria what stone is most common?

Answer 17

calcium oxalate

Question 18

Second most common stone?

Answer 18

struvite

Question 19

Microscopy. Calcium oxalate?

Answer 19

Octahedron (square with X in the center)

Question 20

Microscopy. Calcium phosphate?

Answer 20

Elongated, wedge-shaped; forms rossettes

Question 21

Microscopy. Struvite?

Answer 21

Rectangular prism (coffin lids)

Question 22

Microscopy. Uric acid?

Answer 22

Yellow or red-brown diamond or rhombus.

Question 23

Microscopy. Cystine?

Answer 23

Flat, yellow, hexagonal

Question 24

Risk factor for what stone?

Hypercalciuria (hyperparathyroidysm)?

Answer 24

Calcium stones

Question 25

Risk factor for what stone? | Hyperoxalouria (malabsorbtion, low calcium diet)?

Answer 25

Calcium stones

Question 26

Risk factor for what stone? | Hypocitraturia (eg distal RTA)?

Answer 26

Calcium stones

Question 27

Risk factor for what stone? | Diet rich in Na, proteins, oxalate, and low calcium?

Answer 27

Calcium stones

Question 28

``` Risk factor for what stone? Ethylene glycol (antifreeze) ingestion? ```

Answer 28

Calcium oxalate

Question 29

Risk factor for what stone? | Vitamin C abuse?

Answer 29

Calcium oxalate

Question 30

Risk factor for what stone? Hypocitraturia (assoc with decr. urine pH)?

Answer 30

Calcium oxalate

Question 31

``` Risk factor for what stone? Fat malabsorbtion (eg Cronh disease)? ```

Answer 31

Calcium oxalate

Question 32

Diuretics rreatment of calcium stones?

Answer 32

thiazides

Question 33

low Diet for calcium stones?

Answer 33

Low sodium diet, animal protein and oxalate intake

Question 34

incr. diet for calcium stones?

Answer 34

increase K intake; moderate calcium intake

Question 35

Citrate treatment for what?

Answer 35

Calcium oxalate

Question 36

Risk factor for what stone? recurrent Infection of urease positive bugs (proteus, saprophyticus, klebsiela)

Answer 36

Struvite

Question 37

Risk factor for what stone? | Gout

Answer 37

uric acid

Question 38

Risk factor for what stone? Myeloproliferative disorders (due to cell turnover)

Answer 38

uric acid

Question 39

Risk factor for what stone? dehydration?

Answer 39

all types

Question 40

Treatment of uric acid?

Answer 40

urine alkalinization, allopurinol

Question 41

for what stones allopurinol is treatment?

Answer 41

uric acid

Question 42

Struvite treatment?

Answer 42

stone removal (staghorn), suppressive a/b (erradication of infection)

Question 43

Staghorn calculi?

Answer 43

struvite

Question 44

why urease+ bacterias predispose struvite?

Answer 44

urease hydrolyzes urea to ammonia --> urine alkalinization

Question 45

what stones may be nidus for UTI?

Answer 45

struvite (it creates staghorn calculi)

Question 46

sausas klimatas kuriam yra risk factor?

Answer 46

uric acid

Question 47

Risk factor for what stone? Hereditary condition?

Answer 47

cystine

Question 48

Hereditary (autosomal recessive) condition in which Cystine reabsorbing PCT transporter loses function, causing cystinuria.

Answer 48

.

Question 49

When hereditary condition cause transportation dysfunction, what other substances are not transported?

Answer 49

Cystine, Ornithine, Lysine, Arginine (COLA)

Question 50

Which stones begins in childhood?

Answer 50

cystine (because its hereditary?)

Question 51

what other stones apart struvite can form stoghorn calculi?

Answer 51

cystine

Question 52

Sodium cyanide nitroprusside test positive?

Answer 52

cystine

Question 53

UW step2. Recurrent stones. Causes? 4

Answer 53

Cystinuria Hyperparathyroidims (calcium oxalate stones) Gout Chrohns disease, bariatric surgery (Ca ox)

Question 54

UW step2. Recurrent stones. Prevention. Dietary? 6

Answer 54

Incr. fluids (to produce >2l urine/day) Reduce sodium (< 100 mEq/day) Reduce proteins Normal Ca intake (1200 md/day) Incr. citrate (fruits and vegetables) Reduced oxalate diet for oxalate stones (dark roughage, vit C)

Question 55

UW step2. Recurrent stones. Drug therapy for prevention? 3

Answer 55

Thiazide Urine alkalizination (potassium citrate/bicarbonate salt) Allopurinol (for hyperuricuria-related stones)