Renal Calculi Flashcards Preview

Hugh's MD2 Core Conditions and Presentations > Renal Calculi > Flashcards

Flashcards in Renal Calculi Deck (32):
1

Which medications can cause stones?

Vitamin A B and C, antacid, diuretic, calcium

2

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

3

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

4

What are some good options for home analgesic management of renal colic?

Endocet suppository

Endone

5

How are cysteine stones treated?

Increase urine pH

Fluids

penicillamine

6

What are the most useful biochemical Ix for stones?

Stone biochemistry

24 urine Ca

7

How long do you give someone to pass their stone?

3-6 weeks

8

Is US valuable for the diagnosis of renal calculi?

No

9

How does a person with renal colic appear on observation and examination?

Restless

Non tender at the site of pain

No peritonism

10

When is lithotripsy indicated?

When the stone isn't too large and in the renal pelvis

11

What type of xray is used for investigation of renal calculi? Why is it indicated?

XrayKUB

 

To avoid having to do another CT to follow up

12

Does the location of pain reflect the location of the stone?

No

13

How do you dissolve uric acid stones?

Increase urine pH with bicarb

Flush with water

Allopurinol

14

What are some treatment option for stones?

Conversative management

Dissolve

Destroy - US

Stent

15

Which stones form in acidic conditions? And which form in basic conditions?

Acidic :Uric acid

Cysteine

 

Basic: Calcium phosphate

Struvite

16

What is stemitil?

Prochlorperazine

17

Which type of diuretic causes hypercalcaemia?

Thiazide

18

Which stones are radiolucent?

Uric acid

Cystine

19

What is a phlebolith?

Calcification of a venous valve

- can complicate diagnosis

20

What is the typical medical regimen for acute management of renal colic?

10mg morphine (or 100mg pethadine)

10mg metaclopramide

21

What is the best investigation for stones?

Non-contrast CTKUB

22

What is the character of renal colic?

Colicky/constant

Flank/groin

 

23

How do you investigate the formation of stones?

Water consumption

Gout

Other conditions that cause it

FHx

24

What percentage of renal colic has haematuria?

90%

25

Which stones will pass?

If the diameter is <4mm

26

How is calcium intake related to stone formation?

Inversely

27

How do you advise people on how much water to drink?

Drink until your urine is light yellow

28

What are treatment options for large stones?

Ureteroscopy and disintegration with laser mainly

 

29

How are some types of stones?

Calcium oxalate

Calcium phosphate

Uric acid

Cysteine stones

Struvite

30

What are some lifestyle and medical modifications that can be made?

Remove source

3L urine output per day

Low Na input

Low animal protein

Thiazide

Allopurinol

31

What are some DDx for flank pain?

Appendicitis

Testicular torsion

Biliary colic

Ovarian cyst

Diverticulitis

32

What type of stones can be dissolved medically?

Uric acid