DrVirgo
Forum Hero
Topics: 1096
Posts: 3,514
|
A 49-year-old man has an episode of colicky left flank
pain with radiation to the inner thigh and groin that lasts
for approximately 3 hours and subsides spontaneously.
He is advised by his physician to collect and filter all his
urine, in the hope of identifying the urinary stone that he
is suspected of having passed.He indeed recovers a 2-mm
stone that on further study is determined to be a uric acid
stone. An intravenous pyelogram shows a 3-mm filling
defect present in the left renal pelvis, just above the
ureteropelvic junction, and a CT scan without contrast
shows a bright white spot of the same size on the same
location. Further management should include which of
the following?
(A) Acidification of the urine and increased fluid
intake
(B) Endoscopic extraction of the stone
(C) Long-term antibiotic therapy
(D) Shock wave lithotripsy
(E) Urinary alkalinization and increased fluid intake
___________________
Our greatest glory is not in never falling, but in rising every time we fall.
|
| doc_clotaire
Forum Guru
Topics: 159
Posts: 1,247
|
Stones less than 4 mmm
First :
e ) Urinary alkalinization and increased fluid intake
If it don ' t work you go to
d ) Shock wave lithotripsy
___________________
The elevator to succes is broke ,you must take the stairs
|
| Adam
Forum Senior
Topics: 6
Posts: 136
|
Like what doc_clotaire said. Stones are 2mm in this case, they will pass spontaneously, no need for Shock wave lithotripsy.
the answer is (E)
___________________
I will not say I failed 1000 times.. I will say that I discovered there are 1000 ways that can cause failure ..
|
| DrVirgo
Forum Hero
Topics: 1096
Posts: 3,514
|
Right
E. He passed a uric acid stone
and the remaining stone that he has not passed yet has
the radiologic characteristics of another uric acid stone.
Uric acid stones can be dissolved medically by alkalinization
of the urine.
___________________
Our greatest glory is not in never falling, but in rising every time we fall.
|
|
| |
| | | | |
