Renal Calculi Flashcards Preview

Surg Spec (Urology) > Renal Calculi > Flashcards

Flashcards in Renal Calculi Deck (38)
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1

Where in the urinary tract are renal calculi most likely to be found?

Pelvi-ureteric junction or vesico-ureteric junction

2

What is the typical demographic of individual to be affected by a renal calculi?

Males, aged 20-40

3

What is the most common type of renal calculi?

Calcium oxalate

4

Which two types of renal calculi are not radio-opaque?

Uric acid and cysteine stones

5

Which type of renal calculi can be associated with chemotherapy?

Uric acid stones

6

Which type of renal calculi is often associated with a family history of stones, since they are caused by an inherited metabolic disease?

Cysteine stones

7

Proteus infection is a recognised cause of the formation of which type of renal calculi?

Struvite (triple phosphate) stones

8

Which type of renal calculi is responsible for the formation of a staghorn calculus?

Struvite (triple phosphate) stones

9

Other than being asymptomatic, what are some ways that a renal calculi can present?

Renal colic, haematuria, UTI, obstruction

10

Describe the pain of renal colic?

Colicky, loin to groin pain

11

Describe how a patient with renal colic will typically behave?

They will be restless

12

What is an important non-renal differential diagnosis of renal colic that is important to consider?

AAA

13

What are the most important blood tests to perform in someone with a suspected renal calculi?

U&Es and calcium

14

What is the most common feature seen on urinalysis of someone with renal calculi?

Haematuria

15

What 3 bedside tests should be performed on someone with suspected renal calculi?

Bloods, urinalysis, urine microscopy and culture

16

What is the first line investigation for someone with suspected renal calculi?

KUB-radiograph

17

What is the gold standard, definitive investigation for someone with suspected renal calculi?

CT-KUB

18

Most renal calculi with a diameter of less than what will pass spontaneously without surgery?

< 5mm

19

What initial conservative management is required for all patients with renal calculi?

Maintenance of adequate hydration and analgesia

20

When is urgent intervention required for a patient with renal calculi?

If there is evidence of infection or renal failure

21

Large stones > 5mm which lie in the lower ureter and fail to pass spontaneously can be treated with what?

Extracorporeal shock-wave lithotripsy (ESWL)

22

What is the most appropriate analgesia to give to someone with a renal calculi if there are no contra-indications?

75mg diclofenac IM or IV

23

When should opiate analgesia be used in the management of renal calculi?

If there are contraindications to the use of NSAIDs

24

What medications can be used for medical expulsive therapy of distal ureteric stones which are < 10mm?

Tamsulosin or nifedipine

25

Extracorporeal shock-wave lithotripsy can only be used to break up stones which are less than what diameter?

< 1cm

26

What surgery is used to treat large renal calculi present in the renal pelvis or upper ureter?

Percutaneous nephrolithotomy

27

What are some indications for the use of percutaneous nephrolithotomy as a treatment for renal calculi?

If the calculi is > 3cm in diameter or is a staghorn calculus

28

Renal calculi regularly cause obstruction of the urinary tract which leads to what complication?

Hydronephrosis

29

Loin pain, swinging pyrexia and dysuria may suggest the presence of what complication of renal calculi?

Obstructed infected kidney

30

What is the treatment for an obstructed infected kidney?

Percutaneous nephrostomy