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Renal > renal colic- Nephrolithiasis > Flashcards

renal colic- Nephrolithiasis Flashcards

1
Q

what is renal colic?

A
  • stones form in collecting ducts
  • they are deposited anywhere from renal pelvis to ureter
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2
Q

what are renal colic stones made from?

A
  • 80-85%- are made from calcium oxalate
    others:
  • calcium phosphate
  • uric acid
  • struvite
  • cytesine
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3
Q

what are three commonest obstruction sites for renal colic?

A
  1. PUJ- pelvic-Uteric junction
  2. Pelvic brim- ureters cross over iliac vessels
  3. VUJ- vesico-uteric junction
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4
Q

what are the risk factors for renal colic?

A
  • chronic dehydration
  • kidney primary diseases e.g PKD
  • hyper PTH - hypercalcaemia + hypercalciurea
  • UTI
  • History of previous stone
  • obesity
  • congenital
    -male
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5
Q

describe the pathology behind renal colic?

A
  1. Excess solute of collecting duct
  2. supersaturated urine ( w/ salt and minerals)
  3. crystallisation
  4. stones cause regular outflow obstruction - hydronephrosis (complications)- requires surgical drainage
  5. dilation and obstruction of renal pelvis ( increases damage)
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6
Q

what are the symptoms of renal colic?

A
  1. unilateral loin to groin pain that is colicky - peristaltic waves ( sudden onset)
  2. haematuria + dysuria
  3. patient can’t lie still ( DDx peritonitis- rigidity )
  4. fever - red flag- suggests superimposed infection
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7
Q

what is the first line of diagnosis for renal colic?

A

KUB Xray ( kidney, ureter, bladder)
- 80% specific for renal stones
- cheap and easy

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8
Q

what is the gold standard of diagnosis for renal colic?

A

NCCT KUB ( non contract ct of kidney ureter and bladder)
- 99% specific for stones ( diagnostic)
- rapid but gives background radiation

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9
Q

what bloods are done for diagnosing renal colic?

A
  • FBC
  • U+E
  • CRP
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10
Q

What two other tests are done to diagnose renal colic? what do they look for?

A
  • urine dipstick = UTI
  • urinalysis= haematuria
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11
Q

how is renal colic treated if symptomatic?

A
  • hydration
  • NSAIDs - IV diclofenac for extreme pain
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12
Q

how is renal colic treated if UTI present?

A

antibiotics

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13
Q

how is renal colic treated with lifestyle changes?

A
  • decrease NA + protein intake
  • increase citrus fruits
  • adequate fluid intake
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14
Q

how is renal colic treated for small stones?

A

less than 5mm
- pass spontaneously.

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15
Q

how is renal colic treated for big stones?

A
  • surgical elective treatment
    -EWSL + PCNL
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16
Q

what does EWSL do?

A

break stones into smaller fragments with shock waves

EWSL- Extracorporeal shockwave lithotripsy

17
Q

what does PCNL do?

A

use nephrotic to remove stone

PCNL- percutaneous nephrolithotomy

Renal (14 decks)

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