Nephrolithiasis (Kidney Stones)

WHAT IS IT?

Nephrolithiasis (kidney stones) is a condition characterized by the presence of precipitated solutes in the kidney (which can sometimes transition into the ureter/bladder/urethra).

Source
WHAT CAUSES IT?
WHY IS IT CONCERNING MEDICALLY?
WHAT IS THE INTIAL PRESENTATION?

Patient Chief Complaints:

Detected Medical Problems:

  • Hematuria 
WHAT ARE IMPORTANT ELEMENTS OF THE MEDICAL HISTORY?

Risk Factors:

Medical History:

WHAT ARE IMPORTANT FEATURES OF THE PHYSICAL EXAM?

Vital Signs:

Abdominal Exam:

  • CVA tenderness can be present in some patients with this condition 
CLINICAL WORKUP: URINE STUDIES

Urine sediment may reveal the following findings: 

  • Hematuria 
  • Crystals (needle shaped) can be seen in patients with uric acid stones
CLINICAL WORKUP: IMAGING

Abdominal Ultrasound: may be used in patients who are being worked up for abdominal pain however is not the preferred study for the evaluation of kidney stones. 

Non-Contrast Abdominal/Pelvic CT-Scan: this is the ideal imaging study for the workup of kidney stones. 

CLINICAL WORKUP: OTHER
HOW DO WE NARROW THE DIFFERENTIAL?

Conditions that present similarly and how to exclude them:

WHAT IS OUR THRESHOLD FOR DIAGNOSING THIS CONDITION?
PATIENT MANAGMENT: SYMPTOM RELEIF
PATIENT MANAGEMENT: DISEASE TREATMENT
PATIENT MANAGEMENT: PROPHYLACTIC MEASURES
COULD THIS HAVE BEEN PREVENTED?
ARCHIVE OF STANDARDIZED EXAM QUESTIONS 

This archive compiles standardized exam questions that relate to this topic.

Page Updated: 02.19.2017