kidney stones Flashcards
(27 cards)
what are the common symptoms associated with all kidney stones ?
flank pain
colicky pain
hematuria
what are the risk factors associated with the formation of kidney stones ?
high amount o that substance in the blood
low urine volume - dehydration
what is the most common form of calcium stones ?
calcium oxalate stones
what are the key risk factors for calcium oxalate stones ?
hypercalcemia
high oxalate levels in the blood
what are the causes of high oxalate levels in the blood ?
1- decreased absorption of bile acids - such as with short bowel syndrome
2- excess oxalate from vitamin C metabolism
3- gastric bypass patients
4- crohns disease
how are calcium stones visualised ?
radio opaque
seen on x ray and CT scan
what is the most common etiology of calcium stones ?
idiopathic hypercalciuria
hypercalcemia
high oxalate levels
ethylene glycol
vitamin C abuse
milk alkali syndrome
what is the classic case associated with calcium stones ?
drinking less water
flank pain and hematuria
calcium stone seen on imaging
normal calcium plasma high urinary calcium
what are the features of the urine in association with calcium stones ?
hypocitraturia
high oxalate levels
high urinary calcium
what are the urine crystals like with calcium stones ?
dumbbell or envelope shaped
what is the treatment of calcium stones ?
if they are small they can pass alone
too big ? thiazide diuretics
potassium citrate
how do thiazide diuretics decrease the calcium stones ?
by increasing calcium reabsorption and decreasing urinary calcium
what is the relation between dietary sodium and the formation of calcium kidney stones ?
consuming a high sodium diet
means more ECV
means less RAAS
less sodium resorption
less calcium resorption in the PCT
which means a high sodium diet is associated with high urinary calcium and a higher incidence of calcium stones
what are struvite stones usually a consequence off ?
UTI
what do urine crystals of calcium phosphate stones look like ?
wedge shaped prisms
what type of calculi are associated with struvite stones ?
staghorn calculi
what do the urine crystals look like in association with struvite stones ?
sacrophagus
what is the treatment for struvite stones ?
surgical removal
what are the x ray findings associated with uric acid stones ?
radiolucent
what are the appearance of urine crystals in association with uric acid stones ?
rhomboid or rosette
what are the risk factors associated with uric acid stones ?
gout
acidic urine as with crhonic diarrhea
more common in hot arid climates
seen in diseases with high cell turnover
what is the treatment for uric acid stones ?
alkalanization of the urine with potassium bicarbonate
allopurinol
what is the classic case associated with uric acid stones ?
all the symptoms of a stone with no evidence of a stone on x ray
what is cystine stone associated with ?
cystinuria
form hexagonal stone
