A 24-hr urine collection of a recurrent Ca. oxalate stone former patient having Crohn`s disease might reveal:
high citrate, high oxalate
low citrate, low oxalate
high citrate, low oxalate
low citrate, high oxalate
Correct Answer :
D. low citrate, high oxalate
enteric hyperoxaluria manifests by intestinal malabsorption, low urinary citrate, and low urine volume.
Related Questions
What is the Hounsfield density range of uric acid stones?
400 600 HU
600 800 HU
800 1000 HU
1000 1200 HU
What risk factor(s) promote(s) stone formation?
dehydration
metabolic disorders
congenital anomalies
all of the above
What is the most common organism that might complicate PCNL?
Proteus mirabilis
E. coli
Pseudomonas aeruginosa
Staphylococcus epidermidis
How can the effectiveness of ESWL treatment session be enhanced?
by ensuring optimal coupling of the patient to the lithotripter
by running the treatment at a slower rate (60 shocks/min)
by running the treatment with general anesthesia
by all of the above
What is false concerning staghorn calculus?
commonly unilateral
commonly due to repeated infections
urate stones are the second most common cause of staghorn calculi
ESWL monotherapy with ureteral stenting is the ideal treatment
What does the treatment of hyperuricemia with urate stones include?
oral potassium sodium hydrogen citrate granules
increase hydration
allopurinol
all of the above
What situation carries lower risk for lung injury during supracostal upper pole access for PCNL?
placing the patient in anti-Trendelenburg position
making the puncture under local anesthesia
injection Co2 gas to create a safety space under the diaphragm before puncturing
making the puncture during full expiration
What is the first-line treatment of kidney stones of a burden greater than 2 cm?
ESWL
URS
PCNL
none of the above
Which patient is at lowest risk for the development of perinephric hematoma after ESWL?
hypertensive patient
patient on aspirin withheld 5 days prior to ESWL
a stone in a scared poorly functioning kidney
ESWL every other day
What is true concerning primary hyperparathyroidism and stone formation?
orthophosphates may have a role in the treatment
hyperparathyroidectomy and levothyroxine replacement is the optimum treatment
management includes Calcium chelating agent and repeat 24hr urine collection in 3 months
surgical excision of the adenoma(s) is the treatment of choice
Where do Randall plaques originate from?
transitional epithelium lining minor calyces
transitional epithelium lining major calyces
basement membrane of the loops of Henle
papillary tips of polar pyramids
For how long a completely obstructed ureter could be respited with no expected permanent damage to renal functions?
2 days
2 weeks
2 months
4 6 hrs.
What is false concerning neonatal nephrolithiasis?
frequently caused by loop diuretics
stones are often radiolucent
may be reversed by the use of thiazides
low calcium-to-creatinine ratio predicts stones resolution
What medication could help in managing carbonate apatite stones?
α-Mercaptopropionylglycine
acetohydroxamic acid
carbonic anhydrase inhibitors
xanthine oxidase inhibitors
What bowel surgery could result in enteric hyperoxaluria?
right hemicolectomy
small bowel resection
Roux-en-Y gastric bypass
b & c
What medication(s) could be helpful in the management of cystinuria?
α-Mercaptopropionylglycine
d-Penicillamine
a & b
none of the above
During pyelolithotomy for removing a staghorn urate stone; how to ensure a complete removal of calyceal branches?
by performing intra-operative ultrasonography
by performing radial nephrotomies
by performing adjunct PCLN
by taking a scout KUB film
What is false concerning prostatic stones?
composed of calcium phosphate and calcium carbonate
the vast majority are asymptomatic
most of the calculi are found in the transitional zone
they dont affect PSA levels
What could high level of sulfate in 24-hr. urine collection mean?
dissolving homogenous nucleation
high tendency to form cystine sulfate stones
indicates the amount of dietary protein
post ESWL therapy
What type of stones do laxative abusers might develop?
ammonium urate
sodium urate
calcium oxalate
calcium phosphate
Which of the following factors, positively, affect lower calyceal stone clearance after ESWL?
short and wide infundibulum
large lower-pole infundibulo-pelvic angle
the adjunct usage of PCNL
all of the above
What congenital anomaly is unlikely to result in stone formation?
left ureterocele
bifid right renal pelvis
neurogenic bladder
bilateral UPJ stenosis
What is the preferred irrigation fluid during PCNL?
physiological saline 0.9%
glycine 1.5%
balanced salt solution
distilled water
What stone is inherited as an autosomal recessive trait?
xanthine
ammonium urate
cystine
calcium oxalate dihydrate
What is the sure diagnostic finding of Ca.oxalate stones?
chemical analysis of a recovered stone
hypercalcemia
CT finding
high breakability on ESWL
What is (are) the indication(s) of ureteral stenting before ESWL?
stones in a solitary kidney
ureteral stones causing bilateral obstructions
a kidney stone of ≥ 2.5 cm in size
all of the above
What kind of stones is more likely to recur with infections if not removed completely?
urate
triple phosphate
oxalate monohydrate
matrix
What statement is false concerning the use of desmopressin (DDAVP) in renal colic patients?
it causes reduction in the mean intra-ureteral pressure
it reduces the pain of acute renal colic
it has a direct relaxing effect on the renal pelvis and ureteral musculature
it is indicated when stones are ≤ 4 mm in diameter
Patients having what kind of stones should refrain from eating purines?
cysteine
urate
calcium
none of the above
What is true regarding a stone in a urethral diverticulum?
is symptomless
should undergo a trial of milking out
diverticulectomy and stone extraction is the treatment of choice
ESWL is the preferred treatment option