What is false concerning staghorn calculus?
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
Correct Answer :
D. ESWL monotherapy with ureteral stenting is the ideal treatment
ESWL alone is never enough to treat staghorn stones.
Related Questions
What risk factor(s) promote(s) stone formation?
dehydration
metabolic disorders
congenital anomalies
all of the above
Worldwide, the commonest type of urinary stones is:
calcium monohydrate
calcium oxalate
ammonium urate
none of the above
What sequence of ureteral parts represents the most to least favorable stone response to ESWL treatment?
upper, lower, mid
lower, upper, mid
mid, upper, lower
mid, lower, upper
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
When urine reaches a high tendency to form stones, the situation is called:
lithogenic anion to cation ratio
Randall cut off
saturation index
solubility product
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 (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
What type of stones do laxative abusers might develop?
ammonium urate
sodium urate
calcium oxalate
calcium phosphate
What is the least likely condition to form bladder stones?
spinal cord injury
senile enlargement of prostate
augmented bladder
neurogenic hyper-reflexive bladder
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 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 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
What is true concerning the use of intravenous fluids in renal colic cases?
patients should be given large amounts of fluids to hasten stones passage
fluids are given to keep the patient well hydrated
the recommended regimen is 2 L of ringer lactate over 2 hours
fluids are contraindicated if desmopressin (DDAVP) was given
What is false concerning struvite stones?
the commonest to form staghorn giant calculi
formed by urease producing bacteria
antibiotics have a role in the treatment
form at the two extremes of urinary pH range
What is false concerning preputial stones?
form due to inspissated smegma
form due to stasis of urinary salts
cause inguinal lymphadenopathy
often associated with phimosis in uncircumcised males
What medication(s) could be helpful in the management of cystinuria?
α-Mercaptopropionylglycine
d-Penicillamine
a & b
none of the above
What is the Hounsfield density range of uric acid stones?
400 600 HU
600 800 HU
800 1000 HU
1000 1200 HU
What type of shockwaves is generated by spark-gap technology?
piezoelectric
electrohydraulic
electromagnetic
microexplosive
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 is the most appropriate antibiotic class for prophylaxis before urologic surgery?
aminoglycosides
macrolides
cephalosporins
fluoroquinolones
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
What is false concerning obesity and urinary stone formation?
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
What is the treatment of choice for a 15 mm stone in the lower calyx with a narrow infundibulum?
ESWL
PCNL
radial nephrolithotomy
pyelolithotomy with ureteral stenting
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 stone is inherited as an autosomal recessive trait?
xanthine
ammonium urate
cystine
calcium oxalate dihydrate
What does NOT appear as a filling defect in the renal pelvis on IVU?
fungal ball
radiolucent stone
urothelial growth
upper end of DJ ureteral stent
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
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 kind of stones is more likely to recur with infections if not removed completely?
urate
triple phosphate
oxalate monohydrate
matrix
What type of urinary diversion carries the highest risk of stone formation?
Kock pouch
Neobladder-to-urethra diversion
Florida pouch
Indiana pouch