Ca.phosphate
Ca.oxalate
Na.urate
struvite
B. Ca.oxalate
1000 - 1300 HU density
5 - 10 mm diameter
lower calyx location
mid ureteral location
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
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
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
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
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
ciprofloxacin
indinavir
thiazides
triamterene
Ca.oxalate monohydrate
cystine
matrix
Ca.oxalate dihydrate
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
steinstrasse
a stone in ureterocele
fever, leucocytosis, pain
brushite 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
lithogenic anion to cation ratio
Randall cut off
saturation index
solubility product
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
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
indinavir
magnesium ammonium phosphate
xanthine
matrix
renal insufficiency
active urinary tract infection
uncorrected bleeding disorder
third trimester pregnancy
furosemide
tamsulosin
nifedipine
diclofenac
they are multiple and small in size
usually, they are voided spontaneously
they, rarely, form large stones within the peripheral zone
contrast CT is the conventional method for diagnosis
watchful waiting
open surgical correction
IVU with possible endoscopic ureteral stenting
perc. nephrostomy tube insertion
should be treated with more analgesics
must undergo metabolic worked out
are unlikely to pass out spontaneously
chemolysis should be tried first
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
stones at posterior urethra could be pushed back to the bladder
stones at anterior urethra have to undergo a trial of milking out, using copious intra-urethral xylocaine gel
often respond to a two-week course of tamsulosin
respond to Holmium laser treatment
cysteine
urate
calcium
none of the above
α-Mercaptopropionylglycine
d-Penicillamine
a & b
none of the above
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
to stent the ureter after ureteral surgery
to facilitate stone passage
after a tough ureteroscopy procedure
all of the above
2 days
2 weeks
2 months
4 6 hrs.
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
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
Ca.phosphate
Ca.oxalate
Na.urate
struvite