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
Correct Answer :
C. diverticulectomy and stone extraction is the treatment of choice
typically, the diverticulum mouth is too narrow to milk the stone out, and for the residual fragments post ESWL to drain. Surgical excision of the diverticulum and stone extraction is the preferred option for treatment.
Related Questions
What medication(s) could be helpful in the management of cystinuria?
α-Mercaptopropionylglycine
d-Penicillamine
a & b
none of the above
ESWL in pediatric patients is characterized by all of the following, EXCEPT:
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
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
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 stone is inherited as an autosomal recessive trait?
xanthine
ammonium urate
cystine
calcium oxalate dihydrate
What is the most favorable stone characteristic for PCNL treatment?
≥ 2 cm diameter
upper calyx location
Na.urate composition
600 - 800 HU density
Which patient is at lowest risk for the development of perinephric hematoma after ESWL?
hypertensive patient
patient on aspirin withheld 5 days prior to ESWL
a stone in a scared poorly functioning kidney
ESWL every other day
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 (are) true concerning ESWL?
a stone is fragmented when the force of the shockwaves overcomes the tensile strength of the stone
fragmentation occurs as a result of compressive and tensile forces, erosion, shearing, spalling, and cavitation
the generation of compressive and tensile forces and cavitation are thought to be the most important
all of the above
Which statement is false concerning renal stones related to hyperparathyroidism (HPT)?
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
What could the discomfort experienced during ESWL session be related to?
the energy density of the shock waves as they pass through the skin
the size of the focal point
a & b
none of the above
What medications do NOT cause renal stones?
ciprofloxacin
indinavir
thiazides
triamterene
In what kind of renal stones do antibiotics help most?
indinavir
magnesium ammonium phosphate
xanthine
matrix
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
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 is the incidence risk of ureteral strictures following ureteroscopy?
3 6 %
12 15 %
0.4 0.8 %
0.09 0.14 %
What statement is false concerning the use of desmopressin (DDAVP) in renal colic patients?
it causes reduction in the mean intra-ureteral pressure
it reduces the pain of acute renal colic
it has a direct relaxing effect on the renal pelvis and ureteral musculature
it is indicated when stones are ≤ 4 mm in diameter
Which of the following is a relative contra-indication to ESWL?
renal insufficiency
active urinary tract infection
uncorrected bleeding disorder
third trimester pregnancy
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 least likely condition to form bladder stones?
spinal cord injury
senile enlargement of prostate
augmented bladder
neurogenic hyper-reflexive bladder
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
What is the fatality risk if a triple-phosphate staghorn stone left untreated?
0 10%
10 20%
20 30%
30 40%
Expectant therapy for ureteral stones is indicated when:
stone size of ≤ 4 mm
stone burden of ≥ 22 mm
there is a distal partial obstruction
the patient has end-stage renal failure
What type of shockwaves is generated by spark-gap technology?
piezoelectric
electrohydraulic
electromagnetic
microexplosive
What is the most common organism that might complicate PCNL?
Proteus mirabilis
E. coli
Pseudomonas aeruginosa
Staphylococcus epidermidis
What is false concerning cystine stones?
have diagnostic hexagonal crystals
dont respond to ESWL therapy
are highly soluble in water
inherited in an autosomal recessive fashion
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 false concerning patient`s preparation for PCNL?
active UTI is an absolute contraindication
fluoroquinolone is the first choice for antimicrobial prophylaxis
withholding aspirin for only 10 days is enough
despite sterile urine, stone fragmentation might release hidden bacterial endotoxins and viable bacteria
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
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