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
B. characteristically, urate and cysteine stone are radiolucent
stones at posterior urethra could be pushed back to the bladder
stones at anterior urethra have to undergo a trial of milking out, using copious intra-urethral xylocaine gel
often respond to a two-week course of tamsulosin
respond to Holmium laser treatment
form due to inspissated smegma
form due to stasis of urinary salts
cause inguinal lymphadenopathy
often associated with phimosis in uncircumcised males
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
active UTI is an absolute contraindication
fluoroquinolone is the first choice for antimicrobial prophylaxis
withholding aspirin for only 10 days is enough
despite sterile urine, stone fragmentation might release hidden bacterial endotoxins and viable bacteria
impaired renal tubular calcium reabsorption
excessive glomerular leak of calcium
deficiency of the enzyme xanthine oxidase
hypercalcemia
upper, lower, mid
lower, upper, mid
mid, upper, lower
mid, lower, upper
0 10%
10 20%
20 30%
30 40%
oral potassium sodium hydrogen citrate granules
increase hydration
allopurinol
all of the above
1000 - 1300 HU density
5 - 10 mm diameter
lower calyx location
mid ureteral location
can be placed through perc. nephrostomy
might slip out, especially in females
usually radiopaque
all of the above
spinal cord injury
senile enlargement of prostate
augmented bladder
neurogenic hyper-reflexive bladder
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
cystine
brushite
Ca.oxalate monohydrate
Ca.oxalate dihydrate
calcium monohydrate
calcium oxalate
ammonium urate
none of the above
stones in a solitary kidney
ureteral stones causing bilateral obstructions
a kidney stone of ≥ 2.5 cm in size
all of the above
urate
triple phosphate
oxalate monohydrate
matrix
is symptomless
should undergo a trial of milking out
diverticulectomy and stone extraction is the treatment of choice
ESWL is the preferred treatment option
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
high citrate, high oxalate
low citrate, low oxalate
high citrate, low oxalate
low citrate, high oxalate
blood cells more than pus cells
pus cells if infection was superadded
crystals might appear
all of the above
chemical analysis of a recovered stone
hypercalcemia
CT finding
high breakability on ESWL
a stone in the lower calyx with a wide mouth of infundibulum and obtuse lower calyx to ureter angle
a stone in an anterior group calyceal diverticulum with thin overlying renal parenchyma
5 mm calcium-containing stone in an intrarenal pelvis and wide UPJ
6 years post anatrophic nephrolithotomy, recurrent mid calyceal stone
Kock pouch
Neobladder-to-urethra diversion
Florida pouch
Indiana pouch
cysteine
urate
calcium
none of the above
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
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
renal stones are found in 20% of patients with primary HPT
acidic arrest promotes crystallisation of calcium phosphate stones related to HPT
HPT, vitamin D excess, and malignancy could lead to hypercalcemia and hypercalciuria
only surgery can cure primary HPT
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
renal insufficiency
active urinary tract infection
uncorrected bleeding disorder
third trimester pregnancy
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