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Flashcards in Nephrolithiasis Deck (21)
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1
Q

What are the major 4 types of stones?

A
  1. Calcium (80%)- CaOxalate, CaPhosphate
  2. Uric Acid stones (7%)
  3. Struvite Stones (10-15%)
  4. Cysteine Stones (1%)
2
Q

What organisms make strive stones, and which main organism does not?

A
  1. Proteus mirabilis and Klesiella make it

2. E. Coli does NOT

3
Q

Risk factors for kidney stones?

A
  1. Hyperparathyroidism
  2. Renal Tubular Acidosis
  3. Gout
  4. Diabetes
  5. Highprotein/High Sodium Diets
  6. Inflammatory Bowel Disease
4
Q

What initial lab tests should you do for stones?

A

Calcium, parathyroid hormone, & uric acid

5
Q

What type of urine tests should patients with recurrent stones have?

A

24 hour urine test x 2

  1. Calcium
  2. pH
  3. Calcium
  4. Citrate
  5. Creatinine
  6. Sodium
6
Q

What is the gold standard for diagnosis of kidney stone?

A

Helical CT scan

7
Q

Size of stones and relation to spontaneous passing?

A

<5 mm= 90% pass rate
5-7mm= 50% pass rate
>7 mm= rarely passes

8
Q

How much fluid should patients with kidney stones drink?

A

2.5 L/day

9
Q

What mediations can be given to help the stone pass?

A

CCB, peripheral beta blockers, and alpha 1 antagonists

10
Q

Should you restrict calcium for patients with calcium stones?

A

No, it may result in bone mineralization and increase risk for nephrolithiasis.

11
Q

What diet modifications should person have with kidney stones?

A
  1. Low sodium
  2. Low Oxalate- beets, rhubarb, spinach, greens, okra, tea, chocolate, cocoa, and nuts
  3. Low protein
12
Q

Four different tests and the levels for calcium stone formation?

A
  1. Hypercalcuria
  2. Hypocitraturia
  3. Hyperoxaluria
  4. Hyperuricosuria
13
Q

What do you do for hypercalcuria?

A
  1. Thiazide diuretics

2. NORMAL calcium intake

14
Q

What do you do for hypocitraturia?

A

potassium citrate- it inhibits the precipitation of calcium oxalate

15
Q

What do you do for hyperoxaluria?

A
  • usually with malabsorption from gut

- Can do oxalate binders such as calcium carbonate or cholestyramine

16
Q

What do you do for hyperuricosuria and what do you NOT do?

A
  1. Give Allopurinol

2. Do not give probenecid- it puts more uric acid into the urine

17
Q

What do you do for patients with cystine stones?

A

Send them to nephrologist for management.

18
Q

What medication shouldn’t you give for stones?

A

Lasix, because it will increase calciuria.

19
Q

What causes cystine stones?

A

Autosomal recessive disorder called cystineuria.

20
Q

How many ounces are in a liter?

A

34 Oz=1 Liter

21
Q

When do you start patients on erythropoietin?

A

Hemoglobin <10