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
Correct Answer :
B. location at the lower calyx
stones at lower calyx place an additional challenge to URS treatment.
Related Questions
What sequence of ureteral parts represents the most to least favorable stone response to ESWL treatment?
upper, lower, mid
lower, upper, mid
mid, upper, lower
mid, lower, upper
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 medications do NOT cause renal stones?
ciprofloxacin
indinavir
thiazides
triamterene
What is false concerning the use of antibiotics in stone patients?
they are mandatory when urine shows ≥ 10 WBCs/hpf in symptomatic patients
they aim at treating pyonephrosis and urosepsis
they should cover Escherichia coli and Staphylococcus, Enterobacter, Proteus, and Klebsiella species
All of the above
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 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 proper sequence of the following stones when ordered from most radiopaque to most radiolucent as they appear on plain Xray film?
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
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 is the most favorable stone characteristic for PCNL treatment?
≥ 2 cm diameter
upper calyx location
Na.urate composition
600 - 800 HU density
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 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 most common composition of ureteral stones?
Ca.phosphate
Ca.oxalate
Na.urate
struvite
What is true regarding a stone in a urethral diverticulum?
is symptomless
should undergo a trial of milking out
diverticulectomy and stone extraction is the treatment of choice
ESWL is the preferred treatment option
What parameter is NOT considered in the stone burden concept?
the surface area of the stones
the volume of the stones
the density of the stones
the number of the stones
What type of stones do laxative abusers might develop?
ammonium urate
sodium urate
calcium oxalate
calcium phosphate
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 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 the principal defect in renal hypercalciuria?
impaired renal tubular calcium reabsorption
excessive glomerular leak of calcium
deficiency of the enzyme xanthine oxidase
hypercalcemia
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
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 could high dietary protein result in?
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
What is the least serious complications of PCNL?
uncontrollable bleeding
incomplete removal of stones
pneumothorax
colonic perforation
What kind of stones is most amenable to ESWL?
cystine
brushite
Ca.oxalate monohydrate
Ca.oxalate dihydrate
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
Which of the following dietary advice is recommended for Ca.oxalate stone formers?
limit beef, chicken, pork, eggs, fish, shellfish, and other animal proteins
limit beans, nuts, chocolate, coffee, dark green vegetables, and soda
limit canned, packaged, and fast foods
limit milk, cheese, and other dairy products
What type of stones is soft, resilient, composed of mucoproteins of urine and serum?
matrix
indinavir
brushite
2,8 dihydroxyadenine
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
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 type of urinary diversion carries the highest risk of stone formation?
Kock pouch
Neobladder-to-urethra diversion
Florida pouch
Indiana pouch