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
Correct Answer :
B. stone burden
stone burden entails stones number, surface area, and volume.
Related Questions
What is true regarding prostatic stones?
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
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 most common organism that might complicate PCNL?
Proteus mirabilis
E. coli
Pseudomonas aeruginosa
Staphylococcus epidermidis
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 level of sulfate in 24-hr. urine collection mean?
dissolving homogenous nucleation
high tendency to form cystine sulfate stones
indicates the amount of dietary protein
post ESWL therapy
What is the composition of brushite stones?
calcium phosphate
calcium oxalate monohydrate
sodium urate
2,8 dihydroxyadenine
What is (are) the indication(s) of ureteral stenting before ESWL?
stones in a solitary kidney
ureteral stones causing bilateral obstructions
a kidney stone of ≥ 2.5 cm in size
all of the above
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
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
Invasive intervention in stone patients is NOT indicated in the following condition:
stone size
unrelieved obstruction
infection and septicemia
recurrent stone formation
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
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 the fatality risk if a triple-phosphate staghorn stone left untreated?
0 10%
10 20%
20 30%
30 40%
What condition might NOT cause uric acid stones?
Tumor lysis syndrome
hypoparathyroidism
myeloproliferative disorder
Lesch-Nyhan syndrome
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 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 the incidence risk of ureteral strictures following ureteroscopy?
3 6 %
12 15 %
0.4 0.8 %
0.09 0.14 %
What is true concerning uric acid stones?
they are metabolic stones that form at high urinary pH
they score 800 1000 HU on CT
only 25% of affected patients have Gout disease
affected patients must stop eating animal protein
What does nephrocalcin do?
dissolves cystine stones
enhances nephrocalcinosis process over old scared areas
inhibits Ca.oxalate aggregation and crystallization
plays a secondary role in metastatic calcification process
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
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 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
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
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 type of shockwaves is generated by spark-gap technology?
piezoelectric
electrohydraulic
electromagnetic
microexplosive
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
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
Which of the following bacteria split urea?
Klebsiella pneumonia
Morganella morganii
Proteus mirabilis
all of the above
What is a remarkable disadvantage of ultrasonic imaging for ESWL?
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
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