Question 1

A patient diagnosed with diabetes has symptoms consistent with renal stones. Which type of stone is most likely in this patient?&#10;A) Citrate&#10;B) Cysteine&#10;C) Oxalate&#10;D) Uric acid

Accepted Answer

Patients with diabetes are more prone to develop uric acid stones due to the acidic urine environment caused by insulin resistance and lower urine pH.

Question 2

A patient diagnosed with acute renal colic is experiencing nausea and vomiting. A urinalysis reveals hematuria but is otherwise normal. A radiographic exam shows several radiopaque stones in the ureter which are less than 1 mm in diameter. What will the primary provider do initially to manage this patient?

A) Obtain a consultation with a urology specialist
B) Order a narcotic pain medication and increased oral fluids
C) Prescribe desmopressin and a corticosteroid medication
D) Prescribe nifedipine and hospitalize for intravenous antibiotics

B

Accepted Answer

The patient's symptoms and imaging findings are indicative of acute renal colic caused by small ureteric stones. Nausea and vomiting are common symptoms associated with acute renal colic, and hematuria is a typical finding. The initial management of this patient should include providing pain relief with a narcotic pain medication and increased oral fluids to facilitate stone passage. A consultation with a urology specialist may be needed later if the symptoms persist or if the patient is unable to pass the stones spontaneously. Prescribing desmopressin and a corticosteroid medication or nifedipine and hospitalizing for intravenous antibiotics is not appropriate for this patient's condition.

Question 3

Which factors increase the risk of renal stones? (Select all that apply.)&#10;A) Excess antacid use&#10;B) Living in a cold climate&#10;C) Obesity&#10;D) History of gout&#10;E) Vitamin D excess

Accepted Answer

Excess antacid use, obesity, and a history of gout are all risk factors for renal stones.

Deck 134: Urinary Calculi