Which medications can cause stones?
Vitamin A B and C, antacid, diuretic, calcium
What is the role of alpha-adrenergic receptor blockers in renal calculi?
Cause relaxation of smooth muscle in the ureters to facilitate stone passage and decrease pain
Who do you send home and who do you treat?
Home: painfree after 3 hours
Not: If febrile
If only one kidney or if both kidneys are obstructed
If the pain doesn't settle
What are some good options for home analgesic management of renal colic?
How are cysteine stones treated?
Increase urine pH
What are the most useful biochemical Ix for stones?
24 urine Ca
How long do you give someone to pass their stone?
Is US valuable for the diagnosis of renal calculi?
How does a person with renal colic appear on observation and examination?
Non tender at the site of pain
When is lithotripsy indicated?
When the stone isn't too large and in the renal pelvis
What type of xray is used for investigation of renal calculi? Why is it indicated?
To avoid having to do another CT to follow up
Does the location of pain reflect the location of the stone?
How do you dissolve uric acid stones?
Increase urine pH with bicarb
Flush with water
What are some treatment option for stones?
Destroy - US
Which stones form in acidic conditions? And which form in basic conditions?
Acidic :Uric acid
Basic: Calcium phosphate
What is stemitil?
Which type of diuretic causes hypercalcaemia?
Which stones are radiolucent?
What is a phlebolith?
Calcification of a venous valve
- can complicate diagnosis
What is the typical medical regimen for acute management of renal colic?
10mg morphine (or 100mg pethadine)
What is the best investigation for stones?
What is the character of renal colic?
How do you investigate the formation of stones?
Other conditions that cause it
What percentage of renal colic has haematuria?
Which stones will pass?
If the diameter is <4mm
How is calcium intake related to stone formation?
How do you advise people on how much water to drink?
Drink until your urine is light yellow
What are treatment options for large stones?
Ureteroscopy and disintegration with laser mainly
How are some types of stones?
What are some lifestyle and medical modifications that can be made?
3L urine output per day
Low Na input
Low animal protein
What are some DDx for flank pain?
What type of stones can be dissolved medically?