patho II test 3

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tab
ID:
181773
Filename:
patho II test 3
Updated:
2012-11-06 20:14:43
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urinary stone disease
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Description:
urinary stone disease
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  1. the most commonly presented symptom of nephrolithiasis
    left flank pain
  2. what did the CT scan show
    • 6mm stone in left mid-ureter
    • 1mm stone in inferior calyx of right kidney
  3. any past history of stones
    yes ages 35,43,52 (all passed spontaneously)
  4. what 2 way are stones classified
    • location - kiney, ureter, bladder
    • composition - calcium, struvite, uric acid, cystine
  5. what 2 way are stones classified
    • location - kiney, ureter, bladder
    • composition - calcium, struvite, uric acid, cystine
  6. was there an increase or decrease in incidence rate of stones in the last 10-15 yrs and why
    40% increase, unknown
  7. give the prevelance of stones
    • men, caucasians, between ages 20 & 40,
    • rare in: children and first attach in adults >50
  8. 75% of stone cases are composed of what
    calcium (oxalate or phosphate)
  9. what 5 risk factors did stone patient have
    male, caucasian, sedentary lifestyle, previous stone formation, dehydration
  10. 3 main S&S stones patient had
    • excrutiating pain in the side and back, below the ribs
    • inability to remain still
    • N/V
  11. what is present in the urine in 90% of stone cases
    red blood cells
  12. how does urine pH determine type of stone
    • pH below 5.5 - uric acid or cystine
    • pH above 7.2 - struvite and calcium phosphate
  13. underlying cause of 3 types of stones
    • cystine - congenital cystinuria
    • struvite or carbonate - UTI with urease positive organism
    • primary calcium phosphate - acidification defects
  14. 4 types of kidney stones according to location
    • staghorn - major & minor calices
    • non-staghorn - calyceal or pelvic
    • ureter - anywhere with in
    • bladder - obvioulsly
  15. most abundant organic anion in human urine and 2 roles
    • citrate
    • permits base excretion w/o raising urine pH
    • facilitates excretion of Ca in a soluable form
  16. 4 stone/crystal growth inhibiting substances
    • Tamm-Horsfall protein
    • Potassium citrate
    • pyrophosphate
    • magnesium
  17. 3 invasive treatments for stones
    • shock wave therapy
    • percutaneous nephrolithotomy
    • open operative intervention
  18. what is the treatment for type II hypercalciuria
    reduce Ca intake by 50%
  19. what type of stones did patient have
    calcium oxalate
  20. was specific gravity high or low and why
    high - dehydration
  21. what was recommended, to decrease the intake of, to our patient
    oxalates (fruits, vegetables, nuts)

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