STONES Flashcards
Distal type 1 RTA (impairs secretion of H ions - think topiramate)
inappropriately high urine pH and hypocitraturia = cal phos stones and systemic acidosis
treat with kcit and watch for normal urinary citrate levels
mechanism of action of toradol
eliminating prostaglandin mediated increase in renal blood flow and diuresis. NSAIDs cause a decrease in renal pelvic pressure by a reduction in RBF.
proximal small stone with hydro that you’ve watched for a month
for young kids consider antegrade extraction!
no SWL for <12m of age!!!
remember AUA guidelines when thinking about PCNL…
low dose NC CT first!!
> 1cm lower pole stone burden
PCNL
1.5cm upper pole stone burden
PCNL
cystine / struvite stone burden
PCNL
orange juice is good source of..
potassium
hypercalciuria
low na, increased K and moderate protein restriction - also encourage calcium intake
laxative abuse
dehydration = acidosis and enhanced ammonium excretion and low urine volume/low urine sodium
they will have uric acid and ammonium acid urate stones
IBD
ammonium acid urate
acetohydroxamine acid
for struvite stones
can use for dissolution
watch for DVT / GI distress / headaches
to prevent bladder stones in augmented patient..
1) try irrigations or 2) mucolytic agent (n-acetylcysteine)
ammonium urate acid stones
also seen with UTIs, ua stone formation, BID and laxative abuse
