usmle6789
Forum Senior
Topics: 33
Posts: 49
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63 yr old man is brought to the ER becos of onset of acute severe right sided flank pain. He has 9 yr history of gout. Bp 110/84, pulse 78, RR 16.normal bowel sounds, no masses, no abdominal tenderness. Urinalysis 40 erythrocytes/hpf. Intravenous pyelography confirm a right ureteral calculous. Most likely mechanism of this pt’s urolithiasis?
1] increased urine PH
2] damage to epithelial lining of ureters
3] lack of inhibitors of crystal formation
4] presence of urease splitting bacteria
5] urinary supersaturation with uric acid
my answer is 5 here. not sure though
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| tamriko
Forum Elite
Topics: 23
Posts: 296
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I think so, since he has longstanding gout.
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| ELM
Forum Guru
Topics: 28
Posts: 936
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It's 5...don't even have to think.
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ELM
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