Ureteral stones of ≥ 7 mm:
should be treated with more analgesics
must undergo metabolic worked out
are unlikely to pass out spontaneously
chemolysis should be tried first
Correct Answer :
C. are unlikely to pass out spontaneously
stones < 4 mm in diameter have an 80% chance of spontaneous passage; while stones larger than 8 mm have only 20% chance of passing on their own.
Related Questions
Ureteral stones of ≥ 7 mm:
should be treated with more analgesics
must undergo metabolic worked out
are unlikely to pass out spontaneously
chemolysis should be tried first
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 is false regarding hypomagnesuric calcium nephrolithiasis?
it is characterized by low urinary magnesium and citrate
magnesium increases renal tubular citrate resorption
diarrheal is a remarkable side effect of magnesium therapy
potassium-magnesium preparations might restore urinary magnesium and citrate levels
When should renal stone patients be evaluated for metabolic diseases?
when stones are multiple and/or recurrent
when stones form in childhood
in cases where nephrocalcinosis and urolithiasis are present
all of the above
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
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 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
As per the fixed particle theory of stone formation:
the initial step is papillary plaque formation
crystals formation occurs inside the nephron
tubular precipitates form harmless crystalluria
the attraction of organic compounds and activation crystallization is regulated by osteopontin
What type of urinary diversion carries the highest risk of stone formation?
Kock pouch
Neobladder-to-urethra diversion
Florida pouch
Indiana pouch
Expectant therapy for ureteral stones is indicated when:
stone size of ≤ 4 mm
stone burden of ≥ 22 mm
there is a distal partial obstruction
the patient has end-stage renal failure
What medication(s) could be helpful in the management of cystinuria?
α-Mercaptopropionylglycine
d-Penicillamine
a & b
none of the above
What stones are radiopaque on plain X-ray film?
2,8 dihydroxyadenine stones
sulfa medications-induced stones
calcium oxalate stones
matrix stones
What is the unfavorable stone characteristic for a rigid URS treatment?
size of 5 mm
location at the lower calyx
density of 400 HU
being recurrent
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
Patients having what kind of stones should refrain from eating purines?
cysteine
urate
calcium
none of the above
What are the expected findings on urinalysis in patients with acute renal colic?
blood cells more than pus cells
pus cells if infection was superadded
crystals might appear
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
Which of the following is a relative contra-indication to ESWL?
renal insufficiency
active urinary tract infection
uncorrected bleeding disorder
third trimester pregnancy
What is false regarding DJ ureteral stents?
can be introduced from the bladder or kidney or any part of the ureter`s course
the standard adult size is 32 cm long, 4 mm calibre
might result in encrustations and ureteral obstruction
might result in ureteral dilation
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 risk factor(s) promote(s) stone formation?
dehydration
metabolic disorders
congenital anomalies
all of the above
What medications do NOT cause renal stones?
ciprofloxacin
indinavir
thiazides
triamterene
What could high dietary protein result in?
increase urinary calcium, oxalate, and uric acid excretion
decrease urinary calcium; but increase oxalate, and uric acid excretion
increased urinary calcium and uric acid; but decrease oxalate excretion
decreased urinary calcium, oxalate, and uric acid excretion
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 does the treatment of hyperuricemia with urate stones include?
oral potassium sodium hydrogen citrate granules
increase hydration
allopurinol
all 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
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
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
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 is (are) the indication(s) of hospitalization of ureteral stone patients?
steinstrasse
a stone in ureterocele
fever, leucocytosis, pain
brushite stones