Term
| 80% of kidney stones are : |
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Definition
|
|
Term
| 10% of kidney stones are : |
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Definition
|
|
Term
|
Definition
| magnesium ammonium phosphate (struvite) |
|
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Term
|
Definition
|
|
Term
| calcium oxalate> uric acid> magnesium ammonium phosphate> cystine |
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Definition
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Term
| Risk factor for calcium kidney stones is ___, __% of men with calcium stones have this and __% of women with calcium stones have this. With this there blood calcium is __. 5% of pts with this also have __ ___. 40-50% of patients with this also have ___, citrate normally binds calcium and prevents it from crystallizing. |
|
Definition
- hypercacliuria
- 50% of men
- 75% of women
- primary hyperparathyroidism
- 40-59% have hypocitraturia |
|
|
Term
| Uric acid stones almost always due to: |
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Definition
| hyperuricosuria due to high purine diet (fish, meat, poultry) |
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Term
| Cystine calculi are caused by an inherited __ __ defect leading to : |
|
Definition
- autosomal recessive
- cystinuria |
|
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Term
| Magnesium Ammonium Phosphate Calculi are associated with infection by __ __ __ and are the most common cause of __ __. These are also known as __. |
|
Definition
- urea splitting organsim
- staghorn calculi
- struvite |
|
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Term
| uric acid stones cause ___ urine. |
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Definition
|
|
Term
| infection causes __ urine. |
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Definition
|
|
Term
| Limited pyruia is typical with irritation from a stone, so without bacteria it is not indicative of UTI |
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Definition
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|
Term
| Causes of increased serum calcium: |
|
Definition
- Increases Parathyroid Hormone
- Malignancy
- Granulomatous diseases: Sarcoidosis, Tuberculosis
- Drugs: Thiazide diuretics, Vitamin D intoxication, exogenous Calcium intake
- Familial hypocalciuric hypercalcemia
- Immobilization |
|
|
Term
| Factors of the diet can increase risk of stone formation? |
|
Definition
- Low fluid intake
- High sodium intake
- High protein intake
- Grapefruit juice
- Tomato juice
- Sodas |
|
|
Term
| Diet factors that decrease risk of stone formation: |
|
Definition
- Coffee/tea/wine
- Low calcium intake (not recommended)
- Lowered caloric intake |
|
|
Term
| Sodas increase risk of calcium stone formation b/c the __ __ increases renal excretion of __ and __ __ and decreases the excretion of ___. |
|
Definition
- phoshporic acid
- increases renal excretion of calcium and uric acid
- decreases the excretion of citrate |
|
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Term
| Acute tmt for kidney stones: |
|
Definition
- IV hydration
- NSAIDs
- Narcotics (lots of fluid to avoid constipation)
- Ant-emetics (phenergan) |
|
|
Term
| Long term tmt for calcium stones; |
|
Definition
Thiazide diuretic: lowers urinary excretion of calcium by causing retention of calcium in the bone
- increase fluid intake to greater than 3 liters/day |
|
|
Term
| Long term managment of uric acid stones: |
|
Definition
- decrease protein intake
- Allopurinol decreases production of uric acid
- increase fluid intake |
|
|
Term
| Long term tmt of cystine stones: |
|
Definition
|
|
Term
|
Definition
- difficult
- ESWL (Extracorpeal Shock Wave Lithotripsy)
- Surgery |
|
|
Term
| When is lithotripsy used? |
|
Definition
- calculi unable to pass after a period of time
- stones 8 mm - 2 cm |
|
|
Term
| Large renal stones require: |
|
Definition
| percutaneous nephrolithotomy |
|
|
Term
| Large ureteral stones require surgical removal b/c lithotripsy might not work. |
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Definition
|
|
Term
| Loop diuretics act on the __ __ __ on the __ __ __. |
|
Definition
- thick ascending loop
- NaKCl Triple Cotransporter |
|
|
Term
| Thiazide diuretics act on the __ __ on the __ __. |
|
Definition
- distal tubule
- NaCl contransporter |
|
|
Term
| Potassium sparing diruetics act on the ___ ___. |
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Definition
|
|
Term
| amount excreted = amount filtered - amount reabsorbed + amount secreted |
|
Definition
|
|
Term
filtrate formed/min x plasma concentration = urine volume/min x urine concentration
G x P = U x V
Renal Clearance = (UV)/P |
|
Definition
|
|
Term
| most important extracellular buffer system: |
|
Definition
| Bicarbonate buffer system |
|
|
Term
|
Definition
|
|
Term
| two triggers for ADH release: |
|
Definition
- increases plasma concentration
- decrease plasma volume (decrease bp) stimulates baroreceptors in atrium and large vessels |
|
|
Term
| Regulation of aldosterone levels: |
|
Definition
- RAAS: decreased stretch on granular JG cells, decrased NaCL and flow past macula densa, and direct stimulation by renal nerves (SN) all cause release of renin
- Na and K levels |
|
|
Term
| Aldosterone is made by the __ __. |
|
Definition
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