What is the preferred drug for medical expulsive therapy for lower ureteral stones?
furosemide
tamsulosin
nifedipine
diclofenac
Correct Answer :
B. tamsulosin
tamsulosin a selective α-adrenergic blocker is the preferred agent.
Related Questions
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 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 the favorable stone characteristic for ESWL treatment?
1000 - 1300 HU density
5 - 10 mm diameter
lower calyx location
mid ureteral location
What is true concerning the use of intravenous fluids in renal colic cases?
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
What is the preferred irrigation fluid during PCNL?
physiological saline 0.9%
glycine 1.5%
balanced salt solution
distilled water
On treating uric acid stones, excessive alkalinization with potassium citrate could result in all of the following, EXCEPT:
formation of triple-phosphate stones
infection with Proteus species
increase production of endogenous uric acid
increase level of uric acid in THE blood
What is the incidence risk of ureteral strictures following ureteroscopy?
3 6 %
12 15 %
0.4 0.8 %
0.09 0.14 %
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
How can the effectiveness of ESWL treatment session be enhanced?
by ensuring optimal coupling of the patient to the lithotripter
by running the treatment at a slower rate (60 shocks/min)
by running the treatment with general anesthesia
by all of the above
When should renal stone patients be evaluated for metabolic diseases?
when stones are multiple and/or recurrent
when stones form in childhood
in cases where nephrocalcinosis and urolithiasis are present
all of the above
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 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
What does the treatment of hyperuricemia with urate stones include?
oral potassium sodium hydrogen citrate granules
increase hydration
allopurinol
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
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
Patients having what kind of stones should refrain from eating purines?
cysteine
urate
calcium
none of the above
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 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
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 does NOT appear as a filling defect in the renal pelvis on IVU?
fungal ball
radiolucent stone
urothelial growth
upper end of DJ ureteral stent
What is the sure diagnostic finding of Ca.oxalate stones?
chemical analysis of a recovered stone
hypercalcemia
CT finding
high breakability on ESWL
What is the fatality risk if a triple-phosphate staghorn stone left untreated?
0 10%
10 20%
20 30%
30 40%
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
What is the composition of brushite stones?
calcium phosphate
calcium oxalate monohydrate
sodium urate
2,8 dihydroxyadenine
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 (are) the indication(s) of hospitalization of ureteral stone patients?
steinstrasse
a stone in ureterocele
fever, leucocytosis, pain
brushite stones
What medication(s) could be helpful in the management of cystinuria?
α-Mercaptopropionylglycine
d-Penicillamine
a & b
none 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 condition might NOT cause uric acid stones?
Tumor lysis syndrome
hypoparathyroidism
myeloproliferative disorder
Lesch-Nyhan syndrome