Which of the following is a relative contra-indication to ESWL?
renal insufficiency
active urinary tract infection
uncorrected bleeding disorder
third trimester pregnancy
Correct Answer :
A. renal insufficiency
stone-free rates in patients with renal insufficiency (57%) (serum creatinine level of 22.9 mg/dL) were significantly lower than in patients with better renal function (66%) (serum creatinine level < 2 mg/dL).
Related Questions
What congenital anomaly is unlikely to result in stone formation?
left ureterocele
bifid right renal pelvis
neurogenic bladder
bilateral UPJ stenosis
What is the favorable stone characteristic for ESWL treatment?
1000 - 1300 HU density
5 - 10 mm diameter
lower calyx location
mid ureteral location
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
Which method of the following stone analysis techniques is based on the interaction of polarized light with the stone crystals?
wet chemical analysis
thermogravimetry
scanning electron microscopy
none of the above
What is (are) the indication(s) of using DJ ureteral catheters?
to stent the ureter after ureteral surgery
to facilitate stone passage
after a tough ureteroscopy procedure
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 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 medication could help in managing carbonate apatite stones?
α-Mercaptopropionylglycine
acetohydroxamic acid
carbonic anhydrase inhibitors
xanthine oxidase inhibitors
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 is the incidence risk of ureteral strictures following ureteroscopy?
3 6 %
12 15 %
0.4 0.8 %
0.09 0.14 %
What condition might NOT cause uric acid stones?
Tumor lysis syndrome
hypoparathyroidism
myeloproliferative disorder
Lesch-Nyhan syndrome
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 is false concerning prostatic stones?
composed of calcium phosphate and calcium carbonate
the vast majority are asymptomatic
most of the calculi are found in the transitional zone
they dont affect PSA levels
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
What is the most appropriate antibiotic class for prophylaxis before urologic surgery?
aminoglycosides
macrolides
cephalosporins
fluoroquinolones
Worldwide, the commonest type of urinary stones is:
calcium monohydrate
calcium oxalate
ammonium urate
none of the above
Which of the following bacteria split urea?
Klebsiella pneumonia
Morganella morganii
Proteus mirabilis
all of the above
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
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
How is primary oxaluria treated?
terminal ilium resection
liver transplantation
kidney transplantation
regular hemodialysis
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 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
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 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
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 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 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 false concerning primary bladder stones?
commoner in females than in males
in pediatrics, are of calcium oxalate and/or ammonium urate composition
caused by bladder outlet obstruction
might result in bladder cancer
What is the immediate management of ureteral avulsion on retrieving an upper ureteral stone by a basket?
placement of a percutaneous nephrostomy drain
surgical exploration and primary repair
conservative management
endoscopic retrograde ureteral stenting
What is false concerning primary bladder stones?
commonly occur in patients with senile prostatic enlargement
common in children exposed to low-protein, low-phosphate diet
rarely recur after treatment
respond to ESWL