Nephrolithiasis

Question 1

What are the causes of kidney stones?

Answer 1

Metabolic
- Hyperuricaemia

UTI
Renal tubule defect

Question 2

What type of stones are caused by metabolic causes?

Answer 2

Calcium oxalate

Calcium phosphate

Question 3

What stones are produced from UTIs?

Answer 3

Magnesium aluminium phosphate

Question 4

What stones are created from hyperuricaemia?

Answer 4

Urate

Question 5

Where do the stones form?

Answer 5

Collecting duct

Question 6

Symptoms?

Answer 6

Can be asymptomatic

Pain

• Colicky
• Loin

Infection signs

• Cystitis
• Pyelonephritis

Question 7

What is the typical pattern of pain radiation in nephrolithiasis?

Answer 7

Classically radiates loin to groin

Question 8

What does pain on micturation indicate?

Answer 8

Differentiates bladder stones and ureteric stones

Question 9

Signs?

Answer 9

Haematuria

Proteinuria

Hydronephrosis

Question 10

DDx?

Answer 10

Worry about AAA

Question 11

Tests?

Answer 11

KUB XR/ CT KUB

USS kidney

Question 12

Important blood tests?

Answer 12

Calcium

Phosphate

Urate

Question 13

Why is it very important to test serum urate?

Answer 13

Urate stones are radiolucid

Question 14

Surgical treatment?

Answer 14

ESWL (gold standard)

Percutaneous nephrostomy (remove pressure)

Question 15

What is ESWL?

Answer 15

Extracorporeal shockwave lithotripsy

Question 16

Pharma treatment?

Answer 16

Analgesia

Antibiotics

Question 17

What is the treatment for stones without a blockage?

Answer 17

Increase fluid intake

Sieve urine for stone analysis
- Treat the cause