Renal - Urolithiasis Flashcards Preview

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Flashcards in Renal - Urolithiasis Deck (75)
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1

What is urolithiasis?

The general term referring to a stone in the urinary tract

2

What is a nephrolith?

a stone in the kidney

3

What is a ureterolith?

A stone in the ureter

4

What is a cystolith?

A stone in the urinary bladder

5

What is a urethrolith?

A stone in the urethra

6

True or false: Crystalluria = urolithiasis

NOOOOOOO - the presence of crystals is usually not always a problem

7

What storage method can cause crystal formation?

refrigeration

8

What crystals can be problematic?

ammonium urate - breed? liver dz?
Cystine - breed? Proximal tubular dz?
Struvite + bacteriuria - supports stone presence

9

What is needed to for stone formation?

High solute concentration

10

What are the multifactorial causes of stone formation?

Increased excretion of metabolites, decreased inhibitors of urolith formation, urine pH, and stone retention

11

True or False: Clinical signs often reflect location of urolithiasis

True

12

What clinical signs are associated with lower urinary tract urolithiasis?

hematuria, pollakiuria, stranguria, and obstruction

13

What clinical signs are associated with upper urinary tract uroliths?

systemic signs (uremia) abdominal pain

14

What do you do if you suspect a patient has urolithiasis?

IMAGING!!! - Rads or ultrasound

15

What are the benefits for radiographs in urolith diagnosis?

View of entire urinary tract
Better resolution of stone number/size/shape
Identification of stone helps predict stone composition

16

What are the cons for radiographs in urolith diagnosis?

Cannot see radiolucent stones
Cannot reliable see soft tissue changes

17

What are the benefits for ultrasounding in urolith diagnosis?

Identification of radio-opaque/lucent stones
identification of soft tissue abnormalities

18

What are the cons to ultrasounding in urolith diagnosis?

Limited visualization of the urethra
Poor capacity to determine stone number/size/shape
Cannot use imaging to predict stone composition

19

What uroliths are radio-opaque?

Struvites, calcium oxalate, and silica

20

What uroliths are radio-lucent?

Cystine and urate stones

21

What sized stones may be missed on standard radiographs?

small stones (<2mm)

22

What imaging techniques can be used for urolith diagnosis aside from radiographs and ultrasounding?

contrast cystourethrograms

23

Does a urinalysis allow for the diagnosis of urolithiasis?

No

24

How can pH help in diagnosing a urolith?

It can assist in determining the type

25

How can crystalluria help in diagnosing a urolith?

It can assist in determining the type of you know a stone is present

26

How is USG important in urolithiasis?

High USG can be a risk factor and it is an important monitoring component of therapy

27

What additional testing can be done for urolith diagnosis?

Testing for Azotemia, portosystemic shunt, and pyelonephritis

28

Why can predicting stone composition be useful?

Determine the optimum treatment - surgery or dissolution? Concurrent surgical procedures?

29

Why is stone analysis important?

It is the only way to definitively identify the stone type
Helps determine optimum therapy
Helps identify concurrent diseases

30

How is stone analysis done?

Chemical/optical analysis of the stone

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