ESWL in pediatric patients is characterized by all of the following, EXCEPT:
often need sedation or anesthesia
vesico-ureteral reflux must be excluded
pediatrics have a higher clearance rate of stones when compared to adults
safety measures must be taken to avoid lung contusions
Correct Answer :
B. vesico-ureteral reflux must be excluded
vesico-ureteral reflux, by its self, is not a contraindication for ESWL.
Related Questions
What stones are radiopaque on plain X-ray film?
2,8 dihydroxyadenine stones
sulfa medications-induced stones
calcium oxalate stones
matrix stones
What parameter impairs the kidney stone-free rate, after ESWL?
short skin-to-stone distance (SSD)
end-stage renal failure
a stone in the upper calyx
the presence of a 30 cm, 4.7 Fr ureteral stent in situ
What is the preferred entry point into the collecting system for PCNL for a 2.4 cm renal pelvis stone?
anterior lower pole calyx
posterior lower pole calyx
anterior upper pole calyx
posterior upper pole calyx
What is the least serious complications of PCNL?
uncontrollable bleeding
incomplete removal of stones
pneumothorax
colonic perforation
What is the most common composition of ureteral stones?
Ca.phosphate
Ca.oxalate
Na.urate
struvite
What is (are) the indication(s) of hospitalization of ureteral stone patients?
steinstrasse
a stone in ureterocele
fever, leucocytosis, pain
brushite stones
What is the principal defect in renal hypercalciuria?
impaired renal tubular calcium reabsorption
excessive glomerular leak of calcium
deficiency of the enzyme xanthine oxidase
hypercalcemia
What does nephrocalcin do?
dissolves cystine stones
enhances nephrocalcinosis process over old scared areas
inhibits Ca.oxalate aggregation and crystallization
plays a secondary role in metastatic calcification process
In what kind of renal stones do antibiotics help most?
indinavir
magnesium ammonium phosphate
xanthine
matrix
What is the fatality risk if a triple-phosphate staghorn stone left untreated?
0 10%
10 20%
20 30%
30 40%
What is true regarding prostatic stones?
they are multiple and small in size
usually, they are voided spontaneously
they, rarely, form large stones within the peripheral zone
contrast CT is the conventional method for diagnosis
What is false concerning recurrent stone formation?
best treated by total parathyroidectomy
first-time stone formers are at a 50% risk for recurrence
males have higher recurrence rate than females
stone formers produce stones of the same type every time
What kind of stones is most amenable to ESWL?
cystine
brushite
Ca.oxalate monohydrate
Ca.oxalate dihydrate
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 type of stones is soft, resilient, composed of mucoproteins of urine and serum?
matrix
indinavir
brushite
2,8 dihydroxyadenine
What is the treatment of choice for a 15 mm stone in a mid calyceal diverticulum?
ESWL
PCNL with fulguration of the diverticulum
ureteroscopy with fulguration of the diverticulum
pyelolithotomy with diverticulectomy
What is the preferred drug for medical expulsive therapy for lower ureteral stones?
furosemide
tamsulosin
nifedipine
diclofenac
What type of stones do laxative abusers might develop?
ammonium urate
sodium urate
calcium oxalate
calcium phosphate
What congenital anomaly is unlikely to result in stone formation?
left ureterocele
bifid right renal pelvis
neurogenic bladder
bilateral UPJ stenosis
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 the proper sequence of the following stones when ordered from most radiopaque to most radiolucent as they appear on plain Xray film?
Ca.oxalate, Ca.phosphate, Na.urate, cystine
Ca.phosphate, Ca.oxalate, cystine, Na.urate
Ca.oxalate, Ca.phosphate, cystine, Na.urate
Ca.phosphate, Ca.oxalate, Na.urate, cystine
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 the first-line treatment of kidney stones of a burden greater than 2 cm?
ESWL
URS
PCNL
none of the above
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
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 (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
Which of the following dietary advice is recommended for Ca.oxalate stone formers?
limit beef, chicken, pork, eggs, fish, shellfish, and other animal proteins
limit beans, nuts, chocolate, coffee, dark green vegetables, and soda
limit canned, packaged, and fast foods
limit milk, cheese, and other dairy products
What is false concerning PCNL in horseshoe kidneys?
the preferred access into the collecting system is through a posterior calyx
the posterior calyceal group is typically more medial than in the normal kidney
in most cases the lower pole calyces are posterior
it is desirable to make an upper pole collecting system puncture
What could the discomfort experienced during ESWL session be related to?
the energy density of the shock waves as they pass through the skin
the size of the focal point
a & b
none of the above
What is false concerning the use of antibiotics in stone patients?
they are mandatory when urine shows ≥ 10 WBCs/hpf in symptomatic patients
they aim at treating pyonephrosis and urosepsis
they should cover Escherichia coli and Staphylococcus, Enterobacter, Proteus, and Klebsiella species
All of the above