Stones

Question 1

What causes renal colic?

Answer 1

Spastic ureteral contraction and sudden upper urinary tract dilation due to ureteral obstruction.

Question 2

What percentage of emergency urological visits does renal colic represent?

Answer 2

30-35%

Question 3

What is the most common cause of endoluminal obstruction?

Answer 3

Ureteral stones

Question 4

Where does renal colic pain typically radiate?

Answer 4

Iliac, groin region, genital area, and inner thigh

Question 5

What symptoms often accompany renal colic?

Answer 5

Nausea, vomiting, agitation, macrohematuria

Question 6

What physical test is important in diagnosis?

Answer 6

Giordano’s maneuver

Question 7

What are first-line labs in renal colic?

Answer 7

Serum creatinine, electrolytes, FBC, CRP, urine test, urine culture

Question 8

What is the level I imaging exam?

Answer 8

Abdominal ultrasound

Question 9

What imaging modality identifies the exact location of obstruction?

Answer 9

CT scan

Question 10

What is the first-choice treatment for renal colic pain?

Answer 10

NSAIDs

Question 11

What indicates urgent JJ or nephrostomy placement?

Answer 11

Persistent pain, fever, significant upper tract dilation

Question 12

What is urolithiasis?

Answer 12

Solid crystal formations in the urinary tract

Question 13

Where can urinary stones form?

Answer 13

Calyces, renal pelvis, ureter, bladder, urethra

Question 14

What is the most common type of urinary stone?

Answer 14

Calcium oxalate

Question 15

Which stone type is radiolucent and not seen on X-ray?

Answer 15

Uric acid stones

Question 16

What symptom suggests large, non-obstructing stones?

Answer 16

Lumbar heaviness or discomfort

Question 17

What symptom appears when stones migrate?

Answer 17

Reno-ureteral colic

Question 18

What are the 3 narrowest points of ureter for stone impaction?

Answer 18

UPJ, crossing iliac vessels, UVJ

Question 19

What is a useful diagnostic test for radiopaque stones?

Answer 19

KUB X-ray

Question 20

Why is IVP rarely used now?

Answer 20

Supplanted by CT

Question 21

What does a renogram provide?

Answer 21

Functional information only

Question 22

What is medical therapy for uric acid stones?

Answer 22

Urine alkalinization with bicarbonate or citrate

Question 23

What pH is targeted in uric acid stone treatment?

Answer 23

6.5–7

Question 24

When is litholytic therapy contraindicated?

Answer 24

In ureteral or obstructing stones

Question 25

What is Medical Expulsive Therapy (MET)?

Answer 25

Drug-assisted expulsion of stones <1 cm with pain control and no infection

Question 26

What class of drugs is used in MET?

Answer 26

Alpha-blockers

Question 27

What is ESWL?

Answer 27

Extracorporeal shock wave lithotripsy

Question 28

What stone types are less responsive to ESWL?

Answer 28

Calcium oxalate monohydrate, cystine

Question 29

What patient factor decreases ESWL effectiveness?

Answer 29

Obesity

Question 30

What is Stein Strasse?

Answer 30

A complication where stone fragments align in the ureter post-ESWL

Question 31

What is ureterorenoscopy?

Answer 31

Endoscopic stone removal via the urethra

Question 32

What is RIRS?

Answer 32

Retrograde intrarenal surgery using flexible ureteroscopes

Question 33

What is PCNL used for?

Answer 33

Large renal stones via percutaneous access

Question 34

What is ECIRS?

Answer 34

Simultaneous PCNL and RIRS by two surgeons

Question 35

Why is open surgery rarely used for stones today?

Answer 35

Minimally invasive methods have replaced it

Question 36

When is laparoscopic/robotic surgery used?

Answer 36

When open lithotomy is needed

Question 37

What imaging detects pyelectasia or hydronephrosis?

Answer 37

Ultrasound

Question 38

What does a stone in distal ureter cause?

Answer 38

Bladder irritation and storage symptoms

Question 39

What is a staghorn stone?

Answer 39

Stone occupying the entire renal collecting system

Question 40

What does Giordano’s sign indicate?

Answer 40

Pain response in renal percussion

Question 41

Which stones may smell like sulfur?

Answer 41

Cystine stones

Question 42

How are urinary stones classified?

Answer 42

By composition and location

Question 43

What lab marker indicates infection in renal colic?

Answer 43

Elevated CRP

Question 44

What is an advantage of CT in stone diagnosis?

Answer 44

High sensitivity and anatomic clarity

Question 45

How do impacted stones present?

Answer 45

Persistent pain, reduced urine flow, potential hydronephrosis

Question 46

What stone location causes most severe symptoms?

Answer 46

Ureter

Question 47

What is the main goal in stone treatment?

Answer 47

Relieve obstruction and pain

Question 48

What indicates observation instead of treatment?

Answer 48

Small, non-obstructing renal stones

Question 49

What is the first step in colic with superinfection?

Answer 49

Urgent decompression (JJ or nephrostomy)

Question 50

What is a potential surgical complication of ureteroscopy?

Answer 50

Ureteral injury