nephrolithiasis (W3)

Question 1

what is nephrolithiasis?

Answer 1

kidney stones

Question 2

nephro

Answer 2

kidney

Question 3

renal

Answer 3

belonging to kidney

Question 4

nephrology

Answer 4

study of kidneys

Question 5

urology

Answer 5

study of urinary tract

Question 6

lithos

Answer 6

stone

Question 7

calculi

Answer 7

stone where it shouldn’t be

Question 8

where can a blockage occur?

Answer 8

kidneys
ureters
bladder
ureter opening
urethra
*remember the closer the block is to the kidneys, the more likely there is kidney damage

Question 9

factors that determine how destructive an obstruction is

Answer 9

degree, location, duration, time

Question 10

renal pelvis obstruction

Answer 10

renal calculi

Question 11

ureter obstruction

Answer 11

renal calculi, pregnancy, tumor

Question 12

bladder and ureter obstruction

Answer 12

bladder cancer, neurogenic bladder, prostatic hyperplasia, prostate cancer, urethral strictures

Question 13

complications of an obstruction

Answer 13

1. stasis of urine flow, increases risk of infection
2. back up pressure- hydroureter, hydronephrosis, post renal kidney injury (because of blackage below them)

Question 14

what are manifestations of acute obstruction?

Answer 14

depends on site, cause, speed of onset

primary factor: location of pain, comes in waves

Question 15

so what is nephrolithiasis?

Answer 15

renal calculi or kidney stones
forms in renal pelvis
located from renal pelvis to bladder, excreted via utrethra

defined as: clumps of crystals in the urinary tract

Question 16

risk factors of nephrolithiasis

Answer 16

men
obese
young (20-30 years old)
white
familial history
congenital defect
weather- hot because risk of dehydration

Question 17

etiology of nephrolithiasis

Answer 17

crystallized solutes in urine
depends on: RF/urine characteristics/diet/medications (these things tell you about the kind of stone that is being formed)

Question 18

types of nephrolithiasis

Answer 18

calcium oxalate, struvite, uric acid

Question 19

calcium oxalate (75%)

Answer 19

RF: familial history, idiopathic, increased calcium, increated oxauria

Question 20

struvite (7-10%)

Answer 20

RF: UTI

Question 21

uric acid (7-10%)

Answer 21

RF: arthritis, GOUT

Question 22

explain nephrolithiasis pathogenesis

Answer 22

urine is a solution of solvent AKA water and solutes AKA particles,
a problem occurs when super-saturated with a solute,
when this happens crystals begin to form in the nephron,
the formation is enhanced by dehydration and immobility/sedentary lifestyle

Question 23

calcium oxalate stones

Answer 23

pass eventually

Question 24

struvite “staghorn” calculus

Answer 24

can get really big, must be surgically removed

Question 25

clinical manifestations of acute renal colic

Answer 25

location- flank to groin
radiation
spasms
intermittent
sharp
also… N/V
diaphoresis
increased HR/RR

Question 26

nephrolithiasis pharm

Answer 26

acute pain
-morphine/NSAIDs until passed (helps with pain)
-IV fluids (to stay hydrated)

preventative
-calcium, thiazide diuretics
-struvite, antibiotics
-urate, allopurinol which reduces uric acid, used to prevent GOUT attacks