right hemicolectomy
small bowel resection
Roux-en-Y gastric bypass
b & c
D. b & c
commoner in females than in males
in pediatrics, are of calcium oxalate and/or ammonium urate composition
caused by bladder outlet obstruction
might result in bladder cancer
obese patients have a higher tendency for uric acid stone formation
high-protein, low-carbohydrate diet might increase the risk of stone formation and bone loss
metabolic syndrome is associated with high urinary pH
Roux-en-Y-gastric bypass surgery may increase the risk for stone formation
they are metabolic stones that form at high urinary pH
they score 800 1000 HU on CT
only 25% of affected patients have Gout disease
affected patients must stop eating animal protein
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
terminal ilium resection
liver transplantation
kidney transplantation
regular hemodialysis
0 10%
10 20%
20 30%
30 40%
result from an inherited defect of renal tubular reabsorption of cysteine
characteristically, urate and cysteine stone are radiolucent
cysteine is a dibasic amino acid
on plain X-ray, cysteine stones exhibit ground-glass appearance
formation of triple-phosphate stones
infection with Proteus species
increase production of endogenous uric acid
increase level of uric acid in THE blood
Kock pouch
Neobladder-to-urethra diversion
Florida pouch
Indiana pouch
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
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
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
renal insufficiency
active urinary tract infection
uncorrected bleeding disorder
third trimester pregnancy
placement of a percutaneous nephrostomy drain
surgical exploration and primary repair
conservative management
endoscopic retrograde ureteral stenting
because urine and body secretions are highly concentrated
due to renal leak hypercalciuria
as a result of distal renal tubular acidosis type I
because of reduced or absent of oxalobacter formigenes colonization
subcostal puncture performed during full expiration
previous open nephrolithotomy
access lateral to the posterior axillary line
horseshoe kidney
hypercalciuria and hypocitraturia
hypercalciuria and hypercitraturia
hypocalciuria and hypocitraturia
hypocalciuria and hypercitraturia
Ca.phosphate
Ca.oxalate
Na.urate
struvite
should be treated with more analgesics
must undergo metabolic worked out
are unlikely to pass out spontaneously
chemolysis should be tried first
stone size of ≤ 4 mm
stone burden of ≥ 22 mm
there is a distal partial obstruction
the patient has end-stage renal failure
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
urate
triple phosphate
oxalate monohydrate
matrix
Proteus mirabilis
E. coli
Pseudomonas aeruginosa
Staphylococcus epidermidis
stones in a solitary kidney
ureteral stones causing bilateral obstructions
a kidney stone of ≥ 2.5 cm in size
all of the above
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
furosemide
tamsulosin
nifedipine
diclofenac
the surface area of the stones
the volume of the stones
the density of the stones
the number of the stones
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
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
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