3 6 %
12 15 %
0.4 0.8 %
0.09 0.14 %
A. 3 6 %
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
stone chemical composition
stone burden
first stone vs. recurrent
stone density
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
fungal ball
radiolucent stone
urothelial growth
upper end of DJ ureteral stent
Ca.oxalate, Ca.phosphate, Na.urate, cystine
Ca.phosphate, Ca.oxalate, cystine, Na.urate
Ca.oxalate, Ca.phosphate, cystine, Na.urate
Ca.phosphate, Ca.oxalate, Na.urate, cystine
chemical analysis of a recovered stone
hypercalcemia
CT finding
high breakability on ESWL
piezoelectric
electrohydraulic
electromagnetic
microexplosive
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
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
Tumor lysis syndrome
hypoparathyroidism
myeloproliferative disorder
Lesch-Nyhan syndrome
formation of triple-phosphate stones
infection with Proteus species
increase production of endogenous uric acid
increase level of uric acid in THE blood
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
dehydration
metabolic disorders
congenital anomalies
all of the above
ESWL
PCNL
radial nephrolithotomy
pyelolithotomy with ureteral stenting
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
calcium monohydrate
calcium oxalate
ammonium urate
none of the above
matrix
indinavir
brushite
2,8 dihydroxyadenine
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
cystine
brushite
Ca.oxalate monohydrate
Ca.oxalate dihydrate
2 days
2 weeks
2 months
4 6 hrs.
high citrate, high oxalate
low citrate, low oxalate
high citrate, low oxalate
low citrate, high oxalate
the initial step is papillary plaque formation
crystals formation occurs inside the nephron
tubular precipitates form harmless crystalluria
the attraction of organic compounds and activation crystallization is regulated by osteopontin
blood cells more than pus cells
pus cells if infection was superadded
crystals might appear
all of the above
Proteus mirabilis
E. coli
Pseudomonas aeruginosa
Staphylococcus epidermidis
2,8 dihydroxyadenine stones
sulfa medications-induced stones
calcium oxalate stones
matrix stones
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
upper, lower, mid
lower, upper, mid
mid, upper, lower
mid, lower, upper
aminoglycosides
macrolides
cephalosporins
fluoroquinolones
3 6 %
12 15 %
0.4 0.8 %
0.09 0.14 %
transitional epithelium lining minor calyces
transitional epithelium lining major calyces
basement membrane of the loops of Henle
papillary tips of polar pyramids