What is false concerning patient`s preparation for PCNL?
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
Correct Answer :
B. fluoroquinolone is the first choice for antimicrobial prophylaxis
cephalosporin is the first choice for antimicrobial prophylaxis.
Related Questions
What could carry the least risk of colon injury during PCNL?
subcostal puncture performed during full expiration
previous open nephrolithotomy
access lateral to the posterior axillary line
horseshoe kidney
What is false concerning primary bladder stones?
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
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 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 is (are) the indication(s) of hospitalization of ureteral stone patients?
steinstrasse
a stone in ureterocele
fever, leucocytosis, pain
brushite stones
What is the fatality risk if a triple-phosphate staghorn stone left untreated?
0 10%
10 20%
20 30%
30 40%
What is the most important parameter that determines the treatment modality of a kidney stone?
stone chemical composition
stone burden
first stone vs. recurrent
stone density
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
What type of shockwaves is generated by spark-gap technology?
piezoelectric
electrohydraulic
electromagnetic
microexplosive
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 kind of stones is most amenable to ESWL?
cystine
brushite
Ca.oxalate monohydrate
Ca.oxalate dihydrate
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
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 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
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
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
What type of stones is most effectively treated with PCNL?
Ca.oxalate monohydrate
cystine
matrix
Ca.oxalate dihydrate
What medication could help in managing carbonate apatite stones?
α-Mercaptopropionylglycine
acetohydroxamic acid
carbonic anhydrase inhibitors
xanthine oxidase inhibitors
In what kind of renal stones do antibiotics help most?
indinavir
magnesium ammonium phosphate
xanthine
matrix
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 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
What is the most common organism that might complicate PCNL?
Proteus mirabilis
E. coli
Pseudomonas aeruginosa
Staphylococcus epidermidis
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 the composition of brushite stones?
calcium phosphate
calcium oxalate monohydrate
sodium urate
2,8 dihydroxyadenine
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 type of stones is soft, resilient, composed of mucoproteins of urine and serum?
matrix
indinavir
brushite
2,8 dihydroxyadenine
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
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
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 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