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
Correct Answer :
B. magnesium increases renal tubular citrate resorption
Magnesium decreases renal tubular citrate resorption through the chelation of citrate and therefore increases urinary citrate excretion.
Related Questions
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 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 the use of antibiotics in stone patients?
they are mandatory when urine shows ≥ 10 WBCs/hpf in symptomatic patients
they aim at treating pyonephrosis and urosepsis
they should cover Escherichia coli and Staphylococcus, Enterobacter, Proteus, and Klebsiella species
All of the above
In what kind of renal stones do antibiotics help most?
indinavir
magnesium ammonium phosphate
xanthine
matrix
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 is the most favorable stone characteristic for PCNL treatment?
≥ 2 cm diameter
upper calyx location
Na.urate composition
600 - 800 HU density
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 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 preferred irrigation fluid during PCNL?
physiological saline 0.9%
glycine 1.5%
balanced salt solution
distilled water
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 cystine stones?
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
How does oral Mg.citrate inhibit Ca.oxalate stone formation?
by lowering urinary saturation of Ca.oxalate
by preventing heterogeneous nucleation of Ca.oxalate
by inhibiting spontaneous precipitation and agglomeration of Ca.oxalate
by all 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 is false concerning cystine stones?
have diagnostic hexagonal crystals
dont respond to ESWL therapy
are highly soluble in water
inherited in an autosomal recessive fashion
What bowel surgery could result in enteric hyperoxaluria?
right hemicolectomy
small bowel resection
Roux-en-Y gastric bypass
b & c
What medication could help in managing carbonate apatite stones?
α-Mercaptopropionylglycine
acetohydroxamic acid
carbonic anhydrase inhibitors
xanthine oxidase inhibitors
What is the preferred drug for medical expulsive therapy for lower ureteral stones?
furosemide
tamsulosin
nifedipine
diclofenac
What situation carries lower risk for lung injury during supracostal upper pole access for PCNL?
placing the patient in anti-Trendelenburg position
making the puncture under local anesthesia
injection Co2 gas to create a safety space under the diaphragm before puncturing
making the puncture during full expiration
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 the most important parameter that determines the treatment modality of a kidney stone?
stone chemical composition
stone burden
first stone vs. recurrent
stone density
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
Which of the following factors, positively, affect lower calyceal stone clearance after ESWL?
short and wide infundibulum
large lower-pole infundibulo-pelvic angle
the adjunct usage of PCNL
all of the above
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 parameter impairs the kidney stone-free rate, after ESWL?
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
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 congenital anomaly is unlikely to result in stone formation?
left ureterocele
bifid right renal pelvis
neurogenic bladder
bilateral UPJ stenosis
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 first-line treatment of kidney stones of a burden greater than 2 cm?
ESWL
URS
PCNL
none of the above
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
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