A 55-year-old man comes to the emergency department because of cramps and left-sided flank pain, nausea, and urinary frequency for 3 hours. He has no history of serious illness and takes no medications. He drinks 2-3 alcoholic beverages daily. Temperature is 39.2 C (102.6 F), blood pressure is 90/50 mm Hg, pulse is 102/min, and respirations are 24/min. Examination of the back shows left costovertebral angle tenderness. The patient subsequently undergoes nephrectomy, and a cut section of the resected kidney is shown in the image below. Further evaluation of this patient would most likely reveal which of the following?

Question

A 55-year-old man comes to the emergency department because of cramps and left-sided flank pain, nausea, and urinary frequency for 3 hours. He has no history of serious illness and takes no medications. He drinks 2-3 alcoholic beverages daily. Temperature is 39.2 C (102.6 F), blood pressure is 90/50 mm Hg, pulse is 102/min, and respirations are 24/min. Examination of the back shows left costovertebral angle tenderness. The patient subsequently undergoes nephrectomy, and a cut section of the resected kidney is shown in the image below.  Further evaluation of this patient would most likely reveal which of the following?

Quizplus · Accepted Answer

Eductional Objective: Staghorn calculi are large renal stones that take on the shape of the renal calyces.  They are composed primarily of struvite (magnesium ammonium phosphate) and are associated with recurrent upper urinary tract infections by urease-producing organisms (eg, Proteus, Klebsiella).  Hydrolysis of urea yields ammonia, which alkalinizes the urine and facilitates precipitation of struvite crystals.

A 55-Year-Old Man Comes to the Emergency Department Because of Cramps