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Kidney stones

Kidney stones

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Published by Romberg's sign

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Categories:Types, School Work
Published by: Romberg's sign on Feb 19, 2011
Copyright:Attribution Non-commercial

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01/30/2014

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NEPHROLITHIASIS / RENAL STONES
 
NEPHROLITHIASIS / RENAL STONES
 YOURLECTURER : YOURLECTURER :
 
NEPHROLITHIASIS NEPHROLITHIASIS 
-
Magnitude of Stone disease:
1 out of 5 will have urologic stone in a lifetime7 to 10 of every 1000 hosp. admissions(USA)4/5 cases are male; peak age 25 -35 years (prime of life)
Stones may injure kidneys, produce Renal Failure byinfection or obstruction, cause severe pain or worrisomebleeding. More morbidity occurs than death or ESRD(accounts for 2-3% only of all-cause CKD)Majority of cases, stone dse will accelerate; complexetiology; overall hx is of chronicity and hope of waning asage progresses is for the majority, unrealistic.
Recurrence is the rule: one stone every 2-3 yearsAverage recurrence: 50% within 5 yrs; 60% in 10 yrs
 
MANIFESTATIONS :
Asymptomatic -as long as stone remains attached to renal papillae
Hematuria -may be isolated or associated with pain
Obstruction -typically produce pain from acute obstruction anywherefrom ureteropelvic to ureterovesical junction called
enal colic 
which gradually increases severity over 30 mins to a plateau.
Stone passage -pain begins at flank then moves downward and laterallyalong anterior abdomen to loin, testis or vulva.Stone lodged in ureterovesical junctionpresent as frequency, urgency or dysuriamistaken as UTI.
Staghorn calcuili -can be struvite, cystine or uric acid stones growntoo large, usually in the presence of urease + organisms
Nephrocalcinosis -multiple papillary calcifications commonly seen inRTA and medullary sponge kidneys.
Sludge -precipitate plug of uric acid or cystine crystals
Infection ±flank pain, fever, chills, nausea/vomiting,hypogastric pain

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