Busy. Please wait.

show password
Forgot Password?

Don't have an account?  Sign up 

Username is available taken
show password


Make sure to remember your password. If you forget it there is no way for StudyStack to send you a reset link. You would need to create a new account.
We do not share your email address with others. It is only used to allow you to reset your password. For details read our Privacy Policy and Terms of Service.

Already a StudyStack user? Log In

Reset Password
Enter the associated with your account, and we'll email you a link to reset your password.
Don't know
remaining cards
To flip the current card, click it or press the Spacebar key.  To move the current card to one of the three colored boxes, click on the box.  You may also press the UP ARROW key to move the card to the "Know" box, the DOWN ARROW key to move the card to the "Don't know" box, or the RIGHT ARROW key to move the card to the Remaining box.  You may also click on the card displayed in any of the three boxes to bring that card back to the center.

Pass complete!

"Know" box contains:
Time elapsed:
restart all cards
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.

  Normal Size     Small Size show me how

Stones & Cysts


90% of stones are: radiopaque (visible): Ca & struvite). Uric acid & cystine stones are radiolucent.
Calcium oxalate or Ca phosphate stones 75%; occasionally with chronic hypercalcemia (hyperparathyroidism)
Magnesium – ammonium – phosphate (struvite) stones: prevalence 10-15%
Uric Acid / cystine stones: prevalence (%) Uric Acid 5-8% of all kidney stones. Cystine 1-3%
Stones: DDx AAA; Appendicitis; Tuboovarian Abscess (TOA); Ectopic Pregnancy
Urolithiasis: dx imaging noncontrast CT (high sensitivity); US (hydronephrosis; good for PG); KUB (less specific)
Urolithiasis admission criteria Infection / Sepsis; Complete Obstruction; Deteriorating renal fn; Intractable N/V; Solitary kidney; Very large or proximal stones
Renal stones lodge at: UPJ (kidney stones), ureterovesicular junction/UVJ (bladder stones), or ureter at level of iliac vessels
Urolithiasis RFs Prior stones, FH, low Ca/fluid intake, high oxalate/pro/Na intake, gastric bypass (RYGB); gout, DM, obesity, chronic UTIs, chronic diarrhea
Struvite stones form in pts with: recurrent UTI (urease forming bacteria: proteus / klebsiella). Staghorn: often struvite
Urolithiasis clinical features colicky flank pain +/- hematuria +/- fever/chills, N/V
Symptoms of renal stone in upper ureter: radiate to anterior abdomen
Symptoms of renal stone in lower ureter: radiate to ipsilateral groin, testes/ labia
Symptoms of renal stone in UVJ: urgency, frequency, pelvic pain
ADPKD comorbididities Berry aneurysms of the circle of Willis; cerebellar hemangioblastomas; hepatic cyst; hypertension (<50% of pts); valvular heart dz; divertic; renal failure
Meds contributing to stone formation Antacids, carbonic anhydrase inhibitors (raise urine pH). Loop diuretics (increase urine Ca concentrations), thiazides (uric acid stones). Large doses vitamin C (-> hyperoxaluria)
Dietary factors on stone formation Animal protein metabolism -> metabolic acidosis -> more Ca filtered/hypercaliuria. Meat (purine) -> uric acid. Green leafy (oxalate) -> Ca oxalate stones
Secondary causes of stones HyperPTH, hyperthyroid, Cushing, granulomatous (sarcoid/TB/dissem candida), immobility, vit D intox, bone dz
Kidney stone dx Stone analysis to ID. Noncontrast CT is TOC. US can show obstruction & hydro. 24hr urine, Urine Ca:Cr ratio. Check PTH in chronic pt if Ca elevated.
Kidney stone mgmt IV fluids, analgesia. Most <5mm stones pass spontaneously. 5-10mm may need removal. Diet to lower Ca/ oxalate
UA findings in stones pH <5.0 = uric acid & cystine. pH > 7.2 = struvite
Stones removed by: lithotripsy (ESWL) or ureteroscopy w/extraction. Stones >10mm may require admission for lithotripsy or percutaneous nephrolithotomy
Medullary sponge kidney characteristics Benign. Hereditary AD: MCKD1 or MCKD2 mutation on chromosomes 1 & 16. Dx in 4th-5th decade.
ADPKD genetics Chromosome 16 short arm defect (90%). Chromosome 4 (10-15%), slower w/longer life expectancy
Epithelium-lined cavities filled with fluid or semisolid that develop from renal tubular elements = cysts (70% of all renal masses)
Dx study for medullary sponge kidney Intravenous pyelogram (IVP) - will show striations in papillary portions (=contrast accumulation in dilated collecting ducts)
Large echogenic kidneys on US = ADPKD
Created by: Abarnard