Invasive intervention in stone patients is NOT indicated in the following condition:
stone size
unrelieved obstruction
infection and septicemia
recurrent stone formation
Correct Answer :
D. recurrent stone formation
about 15-20% of patients requires invasive intervention due to stone size, continued obstruction, infection, or intractable pain.
Related Questions
What does the treatment of hyperuricemia with urate stones include?
oral potassium sodium hydrogen citrate granules
increase hydration
allopurinol
all of the above
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
What is the Hounsfield density range of uric acid stones?
400 600 HU
600 800 HU
800 1000 HU
1000 1200 HU
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
What is a remarkable disadvantage of ultrasonic imaging for ESWL?
localization of stones in the ureter is difficult or impossible
inability to visualize stones breaking down in real time
c. patient`s position on ESWL table is uncomfortable
d. inability to visualize radiolucent stones
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
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 metabolic disturbances could result from renal tubular acidosis type I?
hypercalciuria and hypocitraturia
hypercalciuria and hypercitraturia
hypocalciuria and hypocitraturia
hypocalciuria and hypercitraturia
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
What is the immediate management of ureteral avulsion on retrieving an upper ureteral stone by a basket?
placement of a percutaneous nephrostomy drain
surgical exploration and primary repair
conservative management
endoscopic retrograde ureteral stenting
On treating uric acid stones, excessive alkalinization with potassium citrate could result in all of the following, EXCEPT:
formation of triple-phosphate stones
infection with Proteus species
increase production of endogenous uric acid
increase level of uric acid in THE blood
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
What is false concerning primary bladder stones?
commonly occur in patients with senile prostatic enlargement
common in children exposed to low-protein, low-phosphate diet
rarely recur after treatment
respond to ESWL
What is the favorable stone characteristic for ESWL treatment?
1000 - 1300 HU density
5 - 10 mm diameter
lower calyx location
mid ureteral location
What is (are) the indication(s) of using DJ ureteral catheters?
to stent the ureter after ureteral surgery
to facilitate stone passage
after a tough ureteroscopy procedure
all of the above
What is the most favorable stone characteristic for PCNL treatment?
≥ 2 cm diameter
upper calyx location
Na.urate composition
600 - 800 HU density
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 is (are) the indication(s) of hospitalization of ureteral stone patients?
steinstrasse
a stone in ureterocele
fever, leucocytosis, pain
brushite stones
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
Which event is unlikely to occur after placing a DJ ureteral stent?
can be forgotten in place
vesico-renal reflux
calyceal perforation
detrusor irritability and/or hematuria
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
Which of the following is a relative contra-indication to ESWL?
renal insufficiency
active urinary tract infection
uncorrected bleeding disorder
third trimester pregnancy
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 (are) true concerning ESWL?
a stone is fragmented when the force of the shockwaves overcomes the tensile strength of the stone
fragmentation occurs as a result of compressive and tensile forces, erosion, shearing, spalling, and cavitation
the generation of compressive and tensile forces and cavitation are thought to be the most important
all of the above
Two weeks of prolonged wound drainage after a non-stented Anderson-Hynes pyeloplasty. What would be next step in the management?
watchful waiting
open surgical correction
IVU with possible endoscopic ureteral stenting
perc. nephrostomy tube insertion
What type of stones is most effectively treated with PCNL?
Ca.oxalate monohydrate
cystine
matrix
Ca.oxalate dihydrate
What type of stones is soft, resilient, composed of mucoproteins of urine and serum?
matrix
indinavir
brushite
2,8 dihydroxyadenine
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
The process where nucleation and further precipitations occur by different components to form urinary stones, is called:
classical nucleation theory
heterogeneous nucleation
suspension solution
concentric lamination