CAN THO UNIVERSITY OF MEDICINE AND PHARMACY

PROFESSIONAL ENGLISH IN USE MEDICINE

Name Student ID

1. Lương Huỳnh Đức ................................................................... 1753010443

2. Trần Huỳnh Quế Thanh ........................................................... 1753010790

3. Thái Vĩnh Thiện ....................................................................... 1753010791

4. Nguyễn Minh Thuận ................................................................ 1753010792

5. Nguyễn Minh Khôi .................................................................. 1753011147

6. Võ Minh Mẫn ........................................................................... 1753011148

7. Nguyễn Trọng Nhân ................................................................ 1753011150

8. Châu Phúc Nhựt ....................................................................... 1753011151

9. Thi Minh Tâm ........................................................................... 1753011175

I. INTRODUCTION ....................................................................................... 3

II. OVERVIEW URINARY SYSTEMS ....................................................... 3

III. OVERVIEW KIDNEY STONE & CLASSIFICATION...................... 4

IV. EPIDEMIOLOGY & HISTORY ............................................................ 5

V. CAUSES ...................................................................................................... 7

VI. RISK FACTORS ...................................................................................... 9

VII. SIGNS AND SYMPTOMS ..................................................................... 10

VIII. PATHOPHYSIOLOGICAL ................................................................ 12

IX. DIAGNOSIS .............................................................................................. 14

X. TREATMENTS .......................................................................................... 15

XI. PREVENTION.......................................................................................... 18

XII. TRANSLATION .................................................................................... 19

XIII. MINI GAME .......................................................................................... 20

XIV. REFERENCE MATERIAL ................................................................ 20

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I. INTRODUCTION
Kidney stones (renal lithiasis, nephrolithiasis) are hard deposits made of minerals
and salts that form inside your kidneys. Passing kidney stones can be quite painful, but
the stones usually cause no permanent damage if they're recognized in a timely fashion.

II. OVERVIEW URINARY SYSTEMS

The urinary system consists of the kidneys, ureters, urinary bladder, and urethra.
The kidneys filter the blood to remove wastes and produce urine. The ureters, urinary
bladder, and urethra together form the urinary tract, which acts as a plumbing system to
drain urine from the kidneys, the urinary system also maintains the homeostasis of water,
ions, pH, blood pressure, calcium.
The primary organs of the urinary system are the kidneys, which are bean-shaped
organs that are located just below the rib cage in the middle of the back. Urea, together
with water and other waste substances, forms the urine as it passes through the nephrons
and down the renal tubules of the kidney.
From the kidneys, urine travels down two thin tubes, called ureters, to the bladder.
The bladder is a hollow, balloon-shaped organ that is located in the pelvis. The bladder
stores urine until the brain signals the bladder that the person is ready to empty it. A
normal, healthy bladder can hold up to 16 ounces (almost half a liter) of urine
comfortably for two to five hours.
The kidneys maintain the homeostasis of several important internal conditions by
controlling the excretion of substances out of the body. The kidney can control the
excretion of potassium, sodium, calcium, magnesium, phosphate, and chloride ions into
urine. The kidneys monitor and regulate the levels of hydrogen ions (H+) and bicarbonate
ions in the blood to control blood pH.
The kidneys monitor the body’s blood pressure to help maintain homeostasis.
When blood pressure is elevated, the kidneys can help to reduce blood pressure by

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reducing the volume of blood in the body. The kidneys are able to reduce blood volume
by reducing the reabsorption of water into the blood and producing watery, dilute urine.
Direct control of water excretion in the kidneys is exercised by the anti-diuretic
hormone (ADH), released by the posterior lobe of the pituitary gland. ADH causes the
insertion of water channels into the membranes of cells lining the collecting ducts,
allowing water reabsorption to occur. Without ADH, little water is reabsorbed in the
collecting ducts and dilute urine is excreted.

III. OVERVIEW KIDNEY STONE & CLASSIFICATION

Kidney stones (renal lithiasis, nephrolithiasis) are hard deposits made of minerals
and salts that form inside your kidneys.
Kidney stones, or renal calculi, are solid masses made of crystals. Often, stones
form when the urine becomes concentrated, allowing minerals to crystallize and stick
together. Kidney stones usually originate in your kidneys from your kidneys to your
bladder. However, they can develop anywhere along your urinary tract, which consists of
these parts:
• kidneys
• ureters
• bladder
• urethra
Types of kidney stones
Not all kidney stones are made up of the same crystals. The different types of
kidney stones include:
● Calcium:
Calcium stones are the most common. They’re often made of calcium oxalate
(though they can consist of calcium phosphate or maleate). Eating fewer oxalate-rich
foods can reduce your risk of developing this type of stone. High-oxalate foods include:

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  potato chips
 peanuts
 chocolate
 beets
 spinach
However, even though some kidney stones are made of calcium, getting enough
calcium in your diet can prevent stones from forming.
● Uric acid:
This type of kidney stone is more common in men than in women. They can occur
in people with gout or those going through chemotherapy. This type of stone develops
when urine is too acidic. A diet rich in purines can increase urine’s acidic level. Purine is
a colorless substance in animal proteins, such as fish, shellfish, and meats.
● Struvite:
This type of stone is found mostly in women with urinary tract infections (UTIs)
.These stones can be large and cause urinary obstruction. They result from a kidney
infection. Treating an underlying infection can prevent the development of struvite
stones.
● Cystine:
Cystine stones are rare. They occur in both men and women who have the genetic
disorder cystinuria . With this type of stone, cystine - an acid that occurs naturally in the
body - leaks from the kidneys into the urine.

IV. EPIDEMIOLOGY & HISTORY

● Epidemiology:
Kidney stones affect all geographical, cultural, and racial groups. The lifetime risk
is about 10 to 15% in the developed world, but can be as high as 20% to 25% in the
Middle East. The increased risk of dehydration in hot climates, coupled with a diet 50%
lower in calcium and 250% higher in oxalates compared to Western diets, accounts for

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the higher net risk in the Middle East. In the Middle East, uric acid stones are more
common than calcium-containing stones. The number of deaths due to kidney stones is
estimated at 19,000 per year being fairly consistent between 1990 and 2010.
In North America and Europe, the annual number of new cases per year of kidney stones
is roughly 0.5%. In the United States, the frequency in the population of urolithiasis has
increased from 3.2% to 5.2% from the mid-1970s to the mid-1990s.[18] In the United
States, about 9% of the population has had a kidney stone.
The total cost for treating urolithiasis was US$2 billion in 2003.[51] About 65–
80% of those with kidney stones are men; most stones in women are due to either
metabolic defects (such as cystinuria) or infection. Men most commonly experience their
first episode between 30 and 40 years of age, whereas for women, the age at first
presentation is somewhat later. The age of onset shows a bimodal distribution in women,
with episodes peaking at 35 and 55 years. Recurrence rates are estimated at 50% over a
10-year and 75% over 20-year period, with some people experiencing ten or more
episodes over the course of a lifetime.
● History:
The existence of kidney stones was first recorded thousands of years ago, and
lithotomy for the removal of stones is one of the earliest known surgical procedures.In
1901, a stone discovered in the pelvis of an ancient Egyptian mummy was dated to 4,800
BC. Medical texts from ancient Mesopotamia, India, China, Persia, Greece, and Rome all
mentioned calculous disease. Part of the Hippocratic Oath suggests there were practicing
surgeons in ancient Greece to whom physicians were to defer for lithotomies. The Roman
medical treatise De Medicina by Aulus Cornelius Celsus contained a description of
lithotomy, and this work served as the basis for this procedure until the 18th century.
Famous people who were kidney stone formers include Napoleon I, Epicurus,
Napoleon III, Peter the Great, Louis XIV, George IV, Oliver Cromwell, Lyndon B.
Johnson, Benjamin Franklin, Michel de Montaigne, Francis Bacon, Isaac Newton,
Samuel Pepys, William Harvey, Herman Boerhaave, and Antonio Scarpa.

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 New techniques in lithotomy began to emerge starting in 1520, but the operation
remained risky. After Henry Jacob Bigelow popularized the technique of litholapaxy in
1878, the mortality rate dropped from about 24% to 2.4%. However, other treatment
techniques continued to produce a high level of mortality, especially among
inexperienced urologists. In 1980, Dornier MedTech introduced extracorporeal shock
wave lithotripsy for breaking up stones via acoustical pulses, and this technique has since
come into widespread use

V. CAUSES
● Low Urine Volume:
A major risk factor for kidney stones is constant low urine volume. Low urine
volume may come from dehydration (loss of body fluids) from hard exercise, working or
living in a hot place, or not drinking enough fluids. When urine volume is low, urine is
concentrated and dark in color. Concentrated urine means there is less fluid to keep salts
dissolved. Increasing fluid intake will dilute the salts in your urine. By doing this, you may
reduce your risk of stones forming.
Adults who form stones should drink enough fluid to make at least 2.5 liters (⅔
gallon) of urine every day. On average, this will take about 3 liters (100 ounces) of fluid
intake per day. While water is likely the best fluid to drink, what matters most is getting
enough fluid.
● Diet:
Diet can also affect the chance of forming a stone. One of the more common causes
of calcium kidney stones is high levels of calcium in the urine. High urine calcium levels
may be due to the way your body handles calcium. It is not always due to how much
calcium you eat. Lowering the amount of calcium in your diet rarely stops stones from
forming. Studies have shown that restricting dietary calcium can be bad for bone health and
may increase kidney stone risk. Health care providers usually do not tell people to limit
dietary calcium in order to lower urine calcium. But calcium intake should not be too high.

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 Instead of lowering dietary calcium intake, your health care provider may try to
reduce your urine calcium level by decreasing your sodium (salt) intake. Too much salt in
the diet is a risk factor for calcium stones. This is because too much salt is passing into the
urine, keeping calcium from being reabsorbed from the urine and into the blood. Reducing
salt in the diet lowers urine calcium, making it less likely for calcium stones to form.
A diet high in animal protein, such as beef, fish, chicken and pork, can raise the acid
levels in the body and in the urine. High acid levels make it easier for calcium oxalate and
uric acid stones to form. The breakdown of meat into uric acid also raises the chance that
both calcium and uric acid stones will form.
● Bowel Conditions:
Certain bowel conditions that cause diarrhea (such as Crohn's Disease or ulcerative
colitis) or surgeries (such as gastric bypass surgery) can raise the risk of forming calcium
oxalate kidney stones. Diarrhea may result in loss of large amounts of fluid from the body,
lowering urine volume. Your body may also absorb excessive oxalate from the intestine,
resulting in more oxalate in your urine. Both low urine volume and high levels of urine
oxalate can help to cause calcium oxalate kidney stone formation.
● Obesity:
Obesity is a risk factor for stones. Obesity may change the acid levels in the urine,
leading to stone formation.
● Medication:
Some medications, and calcium and vitamin C supplements, may increase your risk
of forming stones. Be sure to tell your health care provider all the medications and
supplements you take, as these could affect your risk of stone formation. Do not stop taking
any of these unless your health care provider tells you to do so.
● Family History:
The chance of having kidney stones is much higher if you have a family history of
stones, such as a parent or sibling.

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VI. RISK FACTORS
Factors that increase your risk of developing kidney stones include:
● Family or personal history:
If someone in your family has kidney stones, you're more likely to develop stones,
too. And if you've already had one or more kidney stones, you're at increased risk of
developing another.
● Dehydration:
Not drinking enough water each day can increase your risk of kidney stones.
People who live in warm climates and those who sweat a lot may be at higher risk than
others.
● Certain diets:
Eating a diet that's high in protein, sodium (salt) and sugar may increase your risk
of some types of kidney stones. This is especially true with a high-sodium diet. Too much
salt in your diet increases the amount of calcium your kidneys must filter and
significantly increases your risk of kidney stones.
● Being obese:
High body mass index (BMI), large waist size and weight gain have been linked to
an increased risk of kidney stones
● Digestive diseases and surgery:
Gastric bypass surgery, inflammatory bowel disease or chronidc diarrhea can
cause changes in the digestive process that affect your absorption of calcium and water,
increasing the levels of stone-forming substances in your urine.
● Other medical conditions:
Diseases and conditions that may increase your risk of kidney stones include renal
tubular acidosis, cystinuria, hyperparathyroidism, certain medications and some urinary
tract infections.

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VII. SIGNS AND SYMPTOMS
There are 8 signs and symptoms of kidney stones
1. Pain in the back, belly, or side:
Kidney stone pain - also known as renal colic - is one of the most severe types of
pain imaginable. Some people who’ve experienced kidney stones compare the pain to
childbirth or getting stabbed with a knife.
The pain is intense enough to account for more than 1 million visits to emergency
rooms each year.
Usually the pain starts when a stone moves into the narrow ureter. This causes
a blockage, which makes pressure build up in the kidney.
The pressure activates nerve fibers that transmit pain signals to the brain.
Kidney stone pain often starts suddenly. As the stone moves, the pain changes
location and intensity.
Pain often comes and goes in waves, which is made worse by the ureters
contracting as they try to push the stone out. Each wave may last for a few minutes,
disappear, and then come back again.
You’ll feel the pain along your side and back, below your ribs. It may radiate to
your belly and groin area as the stone moves down through your urinary tract.
Large stones can be more painful than small ones, but the severity of pain doesn’t
necessarily relate to the size of the stone. Even a little stone can be painful as it moves or
causes a blockage.
2. Pain or burning during urination:
Once the stone reaches the junction between the ureter and bladder, you’ll start to
feel pain when you urinate. Your doctor might call this dysuria.
The pain can feel sharp or burning. If you don’t know you have a kidney stone, you
might mistake it for a urinary tract infection. Sometimes you can have an infection along
with the stone.

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3. Urgent need to go:
Needing to go to the bathroom more urgently or frequently than usual is another
sign that the stone has moved into the lower part of your urinary tract. You may find
yourself running to the bathroom, or needing to go constantly throughout the day and
night.
Urinary urgency can also mimic a urinary tract infection symptom.
4. Blood in the urine:
Blood in the urine is a common symptom in people with urinary tract stones. This
symptom is also called hematuria.
The blood can be red, pink, or brown. Sometimes the blood cells are too small to
see without a microscope (called microscopic hematuria), but your doctor can test for this
symptom.
5. Cloudy or smelly urine:
Healthy urine is clear and doesn’t have a strong odor. Cloudy or foul-smelling
urine could be a sign of an infection in your kidneys or another part of your urinary tract.
One study found that about 8 percent of people with acute kidney stones had a
urinary tract infection.
Cloudiness is a sign of pus in the urine, or pyuria. The smell can come from the
bacteria that cause urinary tract infections. An odor may also come from urine that’s
more concentrated than normal.
6. Going a small amount at a time:
Large kidney stones sometimes get stuck in a ureter. This blockage can slow or
stop the flow of urine.
If you have a blockage, you may only urinate a little bit each time you go. Urine
flow that stops entirely is a medical emergency.
7. Nausea and vomiting:
It’s common for people with a kidney stone to have nausea and vomiting.

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 These symptoms happen because of shared nerve connections between the kidneys
and GI tract. Stones in the kidneys can trigger nerves in the GI tract, setting off an upset
stomach.
The nausea and vomiting can also be your body’s way of responding to intense
pain.
8. Fever and chills:
Fever and chills are signs that you have an infection in your kidney or another part
of your urinary tract. This can be a serious complication to a kidney stone. It can also be a
sign of other serious problems besides kidney stones. Any fever with pain requires urgent
medical attention.
Fevers that occur with an infection are usually high - 100.4˚F (38˚C) or
more. Chills or shivering often occur along with the fever.
►Conclusion:
Call your doctor if you have any symptoms of kidney stones. Get medical help right away
if you have these symptoms, which could indicate that you have an infection or other
serious complication:
 pain so severe that you can’t get comfortable
 nausea, vomiting, fever, or chills with the pain
 blood in your urine
 trouble urinating

VIII. PATHOPHYSIOLOGICAL
● Mode of stone growth:
1. Nucleation:
Nucleation is the process by which free ions in solution associate into microscopic
particles.

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2. Aggregation:
Aggregation is a process by which there is agglomeration of crystals that form in
free solution into larger multicomponent particles.
3. Crystal Growth:
Growth of microscopic crystals is accomplished by movement of ions out of
solution onto the growing crystal. While some growth of nuclear crystals must occur by
movement of ions from solution, this is clearly a limited process, as giant single crystals
of stone constituents are not generally observed.
● Site of stone growth:
1. Randall’s plaques:
Although urine is not generally supersaturated with respect to calcium phosphate
such conditions may exist in the loop of Henle.This may lead to precipitation of calcium
phosphate in interstitial sites in the inner medulla. These deposits often become extensive
enough to be visible macroscopically in the form of Randall’s Plaques

2. Calcium oxalate “receptors” in collecting duct epithelium:

Cells exposed to crystals may internalize them, where their fate may involve
dissolution or they may undergo transcytosis through the epithelial layer. Additional
consequences include membrane lysis, necrosis of cells, apoptosis, and production of
reactive oxygen species
● Promoter of stone formation:
1. Uric acid or Urate:
Monosodium urate appears to directly reduce the formation product for calcium
oxalate.
2. Urine pH:
Highly acid urine leading to precipitation of uric acid crystals may not only lead to
uric acid stone disease but may also enhance calcium oxalate crystallization due to

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heterogeneous crystallization, in which one type of crystal acts as a template, thereby
promoting crystallization of a second type of crystal

IX. DIAGNOSIS
Diagnosis of kidney stones requires a complete health history assessment and a physical
exam. Other tests include:
- Blood tests for calcium, phosphorus, uric acid, and electrolytes
- Blood urea nitrogen (BUN) and creatinine to assess kidney functioning
- Urinalysis to check for crystals, bacteria, blood, and white cells
- Examination of passed stones to determine their type
The following tests can rule out obstruction:
- abdominal X-rays
- intravenous pyelogram (IVP)
(Intravenous pyelogram (IVP) is an x-ray exam that uses an injection of
contrast material to evaluate your kidneys, ureters and bladder and help diagnose blood in
the urine or pain in your side or lower back. An IVP may provide enough information to
allow your doctor to treat you with medication and avoid surgery.)
- Retrograde pyelogram
- Ultrasound of the kidney (the preferred study)
- MRI scan of the abdomen and kidneys
- Abdominal CT scan
The contrast dye used in the CT scan and the IVP can affect kidney function. However, in
people with normal kidney function, this isn’t a concern.

X. TREATMENTS
Treatment for kidney stones are varies, depend on the type of stone and the cause.
Treatment is directed toward control of symptoms.

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Small stones with minimal symptoms
Most small kidney stones won't require invasive treatment. You may be able to
pass a small stone by:
● Drinking water:
Drinking as much as six to eight glasses of water a day (about 1.9 to 2.8 liters) a
day may help flush out your urinary system and increase your urine flow. Unless your
doctor tells you otherwise, drink enough fluid — mostly water — to produce clear or
nearly clear urine. People who have severe nausea and vomiting may need intravenous
fluids.
● Pain relievers:
Passing a small stone can cause some discomfort. To relieve mild pain, your
doctor may recommend pain relievers such as ibuprofen (Advil, Motrin IB, others),
acetaminophen (Tylenol, orthers) or naproxen sodium (Aleve). Acetaminophen may be
used as pain medication if there is no contraindication to its use.
● Medical therapy:
Your doctor may give you a medication to help pass your kidney stone. This type
of medication, known as an alpha blocker such as tamsulosin (Flomax), relaxes the
muscles in your ureter, helping you pass the kidney stone more quickly and with less
pain.
Large stones and those that cause symptoms
Kidney stones that can't be treated with conservative measures - either because
they're too large to pass on their own or because they cause bleeding, kidney damage or
ongoing urinary tract infections - may require more - extensive treatment. Procedures
may include:
● Lithotripsy:
For certain kidney stones - depending on size and location - your doctor may
recommend a procedure called extracorporeal shock wave lithotripsy (ESWL).

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ESWL uses sound waves to create strong vibrations (shock waves) that break the stones
into tiny pieces that can be passed in your urine. The procedure lasts about 45 to 60
minutes and can cause pain, so you may be under sedation or light anesthesia to make
you fell uncomfortable as the stone fragments pass through the urinary tract. Moreover,
ESWL can cause blood in the urine, bruising on the back or abdomen, bleeding around
the kidney and other adjacent organs. It can cause bruising on the abdomen and back and
bleeding around the kidney and nearby organs.
Toradol, aspirin, and NSAIDs must be avoided if lithotripsy is to be done because
of the increased risk of bleeding or if there is impaired kidney function.
● Tunnel surgery:
Surgery to remove giant stones in the kidney. A procedure called tunnel surgery or
percutaneous nephrolithotomy involves surgically removing a kidney stone using small
telescopes and instruments inserted through a small incision in your back. This procedure
and may be needed when:

- the stone causes obstruction and infection or is damaging the kidneys

- the stone has grown too large to pass
- pain can’t be controlled
You will receive general anesthesia during the surgery and be in the hospital for
one to two days while you recover. Your doctor may recommend this surgery if ESWL
was unsuccessful.
● Ureteroscopy:
When a stone is stuck in the ureter or bladder, your doctor may use an instrument
called a ureteroscope to remove it. A small thin lighted tube equipped with a camera
which is inserted into the urethra and passed into the bladder. The doctor then uses a
small cage to snag the stone and remove it. The stone is then sent to the laboratory for
analysis.
Once the stone is located, special tools can snare the stone or break it into pieces
that will pass in your urine. Your doctor may then place a small tube (stent) in the ureter
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to relieve swelling and promote healing. You may need general or local anesthesia during
this procedure.
● Parathyroid gland surgery:
Some calcium phosphate stones are caused by overactive parathyroid glands,
which are located on the four corners of your thyroid gland, just below your Adam's
apple. When these glands produce too much parathyroid hormone (hyperparathyroidism),
your calcium levels can become too high and kidney stones may form as a result.
Hyperparathyroidism sometimes occurs when a small, benign tumor forms in one
of your parathyroid glands or you develop another condition that leads these glands to
produce more parathyroid hormone. Removing the growth from the gland stops the
formation of kidney stones. Or your doctor may recommend treatment of the condition
that's causing your parathyroid gland to overproduce the hormone.

XI. PREVENTION

● Get the calcium you need:

Getting too little calcium in your diet can cause oxalate levels to rise and cause
kidney stones. To prevent this, make sure to take in an amount of calcium appropriate to
your age. Ideally, obtain calcium from foods, since some studies have linked taking
calcium supplements to kidney stones. Men 50 and older should get 1,000 milligrams
(mg) of calcium per day, along with 800 to 1,000 international units (IU) of vitamin D to
help the body absorb the calcium.

● Reduce sodium:

A high-sodium diet can trigger kidney stones because it increases the amount of
calcium in your urine. So a low-sodium diet is recommended for the stone prone. Current
guidelines suggest limiting total daily sodium intake to 2,300 mg. If sodium has

17
contributed to kidney stones in the past, try to reduce your daily intake to 1,500 mg. This
will also be good for your blood pressure and heart.

● Limit animal protein:

Eating too much animal protein, such as red meat, poultry, eggs, and seafood,
boosts the level of uric acid and could lead to kidney stones. A high-protein diet also
reduces levels of citrate, the chemical in urine that helps prevent stones from forming. If
you’re prone to stones, limit your daily meat intake to a quantity that is no bigger than a
pack of playing cards. This is also a heart-healthy portion.

● Avoid stone-forming foods:

Beets, chocolate, spinach, rhubarb, tea, and most nuts are rich in oxalate, and colas
are rich in phosphate, both of which can contribute to kidney stones. If you suffer from
stones, your doctor may advise you to avoid these foods or to consume them in smaller
amounts.

Some studies have shown that men who take high doses of vitamin C in the form
of supplements are at slightly higher risk of kidney stones. That may be because the body
converts vitamin C into oxalate.

● Taking supplements and vitamins:

A wide range of natural supplements and vitamins may help reduce the risk of
kidney stones, including: Potassium citrate; vitamin B-6, which is found in foods such
as bananas, mangos, soybeans, avocados, and halibut; pyridoxine supplements; fish oil.

XII. TRANSLATION
Breaking stones apart
Bladder stones are often removed during a procedure called a cystolitholapaxy. A
small tube with a camera at the is inserted through your urethra and into your bladder to

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view the stone. Your doctor then uses a laser, ultrasound or mechanical device to break
the stone into small pieces and flushes the pieces from your bladder.
Hand-held lithotripters use ultrasonic energy to break up the stone into pieces
small enough to pass in the urine. Holmium laser lithotripsy uses a laser to break up the
stone.
Before the procedure, you'll likely be given an anesthetic that numbs the lower
part of your body (regional anesthesia) or that makes you unconscious and unable to feel
pain (general anesthesia). Complications from a cystolitholapaxy aren't common, but
urinary tract infections, fever, a tear in your bladder or bleeding can occur. Your doctor
may give you antibiotics before and after the procedure to reduce the risk of infections.
About a month after the cystolitholapaxy, your doctor will likely confirm that
there are no remaining stone fragments in your bladder.

XIII. MINI GAME

Question 1: ... is the process by which the nephron removes water and solutes from
the tubular fluid and returns them to the circulating blood (REABSORPTION)
Question 2: A doctor who specializes in kidney diseases is called a …
(NEPHROLOGIST)
Question 3: The patient says “I passed some blood in my urine”. His symtom is …
(HAEMATURIA)
Question 4: Burning or scalding pain in the urethra when passing urine is … (DYSURIA)
Question 5: What are these ? (ADRENAL GLAND)

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Question 6: What tube carries urine outside the body from the bladder? (URETHRA)
Question 7: The patient has to get up three times at night to pass water. He suffers from
… (NOCTURIA)

XIV. REFERENCE MATERIAL

1. http://www.innerbody.com/image/urinov.html

2. https://www.livescience.com/27012-urinary-system.html

3. https://en.wikibooks.org/wiki/Human_Physiology/The_Urinary_System

4. https://en.wikipedia.org/wiki/Kidney_stone_disease

5. https://www.webmd.com/kidney-stones/ss/slideshow-kidney-stones-overview

6. https://www.medicalnewstoday.com/articles/154193.php

7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3252394

8. https://www.healthline.com/health/kidney-stones

9. https://www.urologyhealth.org/urologic-conditions/kidney-stones

10. https://www.emedicinehealth.com/kidney_stones/article_em.htm

11. https://patient.info/health/kidney-stones

12. https://www.mayoclinic.org/diseases-conditions/kidney-stones/symptoms-

causes/syc-20355755

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 13. https://www.kidney.org/blog/kidney-cars/risk-factors-increase-your-chances-

getting-kidney-stones

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