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
Correct Answer :
B. end-stage renal failure
stones in anuric patients dont pass down, thus ESWL is not a suitable treatment option.
Related Questions
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
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 medication could help in managing carbonate apatite stones?
α-Mercaptopropionylglycine
acetohydroxamic acid
carbonic anhydrase inhibitors
xanthine oxidase inhibitors
Patients having what kind of stones should refrain from eating purines?
cysteine
urate
calcium
none of the above
What is the Hounsfield density range of uric acid stones?
400 600 HU
600 800 HU
800 1000 HU
1000 1200 HU
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
In what kind of renal stones do antibiotics help most?
indinavir
magnesium ammonium phosphate
xanthine
matrix
Invasive intervention in stone patients is NOT indicated in the following condition:
stone size
unrelieved obstruction
infection and septicemia
recurrent stone formation
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 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 medication(s) could be helpful in the management of cystinuria?
α-Mercaptopropionylglycine
d-Penicillamine
a & b
none of the above
What is the first-line treatment of kidney stones of a burden greater than 2 cm?
ESWL
URS
PCNL
none of the above
What is the preferred irrigation fluid during PCNL?
physiological saline 0.9%
glycine 1.5%
balanced salt solution
distilled water
What kind of stones is most amenable to ESWL?
cystine
brushite
Ca.oxalate monohydrate
Ca.oxalate dihydrate
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 stone is inherited as an autosomal recessive trait?
xanthine
ammonium urate
cystine
calcium oxalate dihydrate
What is the preferred drug for medical expulsive therapy for lower ureteral stones?
furosemide
tamsulosin
nifedipine
diclofenac
What is the least likely condition to form bladder stones?
spinal cord injury
senile enlargement of prostate
augmented bladder
neurogenic hyper-reflexive bladder
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 false concerning recurrent stone formation?
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
What is true concerning primary hyperparathyroidism and stone formation?
orthophosphates may have a role in the treatment
hyperparathyroidectomy and levothyroxine replacement is the optimum treatment
management includes Calcium chelating agent and repeat 24hr urine collection in 3 months
surgical excision of the adenoma(s) is the treatment of choice
What medications do NOT cause renal stones?
ciprofloxacin
indinavir
thiazides
triamterene
Two weeks of prolonged wound drainage after a non-stented Anderson-Hynes pyeloplasty. What would be next step in the management?
watchful waiting
open surgical correction
IVU with possible endoscopic ureteral stenting
perc. nephrostomy tube insertion
What is the most common organism that might complicate PCNL?
Proteus mirabilis
E. coli
Pseudomonas aeruginosa
Staphylococcus epidermidis
What type of stones is most effectively treated with PCNL?
Ca.oxalate monohydrate
cystine
matrix
Ca.oxalate dihydrate
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 the incidence risk of ureteral strictures following ureteroscopy?
3 6 %
12 15 %
0.4 0.8 %
0.09 0.14 %
What bowel surgery could result in enteric hyperoxaluria?
right hemicolectomy
small bowel resection
Roux-en-Y gastric bypass
b & c
What is false concerning urethral stones?
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