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
Correct Answer :
A. placement of a percutaneous nephrostomy drain
placement of a percutaneous nephrostomy drain is the immediate management of avulsed ureter.
Related Questions
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 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 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 is the first-line treatment of kidney stones of a burden greater than 2 cm?
ESWL
URS
PCNL
none of the above
In what kind of renal stones do antibiotics help most?
indinavir
magnesium ammonium phosphate
xanthine
matrix
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
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
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 the composition of brushite stones?
calcium phosphate
calcium oxalate monohydrate
sodium urate
2,8 dihydroxyadenine
What is the favorable stone characteristic for ESWL treatment?
1000 - 1300 HU density
5 - 10 mm diameter
lower calyx location
mid ureteral location
What is true regarding DJ ureteral stents?
can be placed through perc. nephrostomy
might slip out, especially in females
usually radiopaque
all of the above
What type of stones do laxative abusers might develop?
ammonium urate
sodium urate
calcium oxalate
calcium phosphate
What risk factor(s) promote(s) stone formation?
dehydration
metabolic disorders
congenital anomalies
all of the above
What is the most favorable stone characteristics for laparoscopic and robotic approaches for the treatment of a kidney stone?
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
What is false concerning recurrent stone formation?
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
What is the treatment of choice for a 15 mm stone in a mid calyceal diverticulum?
ESWL
PCNL with fulguration of the diverticulum
ureteroscopy with fulguration of the diverticulum
pyelolithotomy with diverticulectomy
Patients having what kind of stones should refrain from eating purines?
cysteine
urate
calcium
none of the above
What type of stones is most effectively treated with PCNL?
Ca.oxalate monohydrate
cystine
matrix
Ca.oxalate dihydrate
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 medication could help in managing carbonate apatite stones?
α-Mercaptopropionylglycine
acetohydroxamic acid
carbonic anhydrase inhibitors
xanthine oxidase inhibitors
What is the preferred entry point into the collecting system for PCNL for a 2.4 cm renal pelvis stone?
anterior lower pole calyx
posterior lower pole calyx
anterior upper pole calyx
posterior upper pole calyx
What is the most common organism that might complicate PCNL?
Proteus mirabilis
E. coli
Pseudomonas aeruginosa
Staphylococcus epidermidis
What metabolic disturbances could result from renal tubular acidosis type I?
hypercalciuria and hypocitraturia
hypercalciuria and hypercitraturia
hypocalciuria and hypocitraturia
hypocalciuria and hypercitraturia
What congenital anomaly is unlikely to result in stone formation?
left ureterocele
bifid right renal pelvis
neurogenic bladder
bilateral UPJ stenosis
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 is the incidence risk of ureteral strictures following ureteroscopy?
3 6 %
12 15 %
0.4 0.8 %
0.09 0.14 %
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
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
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