Flashcards in Renal - Urolithiasis Deck (75)
What is urolithiasis?
The general term referring to a stone in the urinary tract
What is a nephrolith?
a stone in the kidney
What is a ureterolith?
A stone in the ureter
What is a cystolith?
A stone in the urinary bladder
What is a urethrolith?
A stone in the urethra
True or false: Crystalluria = urolithiasis
NOOOOOOO - the presence of crystals is usually not always a problem
What storage method can cause crystal formation?
What crystals can be problematic?
ammonium urate - breed? liver dz?
Cystine - breed? Proximal tubular dz?
Struvite + bacteriuria - supports stone presence
What is needed to for stone formation?
High solute concentration
What are the multifactorial causes of stone formation?
Increased excretion of metabolites, decreased inhibitors of urolith formation, urine pH, and stone retention
True or False: Clinical signs often reflect location of urolithiasis
What clinical signs are associated with lower urinary tract urolithiasis?
hematuria, pollakiuria, stranguria, and obstruction
What clinical signs are associated with upper urinary tract uroliths?
systemic signs (uremia) abdominal pain
What do you do if you suspect a patient has urolithiasis?
IMAGING!!! - Rads or ultrasound
What are the benefits for radiographs in urolith diagnosis?
View of entire urinary tract
Better resolution of stone number/size/shape
Identification of stone helps predict stone composition
What are the cons for radiographs in urolith diagnosis?
Cannot see radiolucent stones
Cannot reliable see soft tissue changes
What are the benefits for ultrasounding in urolith diagnosis?
Identification of radio-opaque/lucent stones
identification of soft tissue abnormalities
What are the cons to ultrasounding in urolith diagnosis?
Limited visualization of the urethra
Poor capacity to determine stone number/size/shape
Cannot use imaging to predict stone composition
What uroliths are radio-opaque?
Struvites, calcium oxalate, and silica
What uroliths are radio-lucent?
Cystine and urate stones
What sized stones may be missed on standard radiographs?
small stones (<2mm)
What imaging techniques can be used for urolith diagnosis aside from radiographs and ultrasounding?
Does a urinalysis allow for the diagnosis of urolithiasis?
How can pH help in diagnosing a urolith?
It can assist in determining the type
How can crystalluria help in diagnosing a urolith?
It can assist in determining the type of you know a stone is present
How is USG important in urolithiasis?
High USG can be a risk factor and it is an important monitoring component of therapy
What additional testing can be done for urolith diagnosis?
Testing for Azotemia, portosystemic shunt, and pyelonephritis
Why can predicting stone composition be useful?
Determine the optimum treatment - surgery or dissolution? Concurrent surgical procedures?
Why is stone analysis important?
It is the only way to definitively identify the stone type
Helps determine optimum therapy
Helps identify concurrent diseases