sandra
Forum Guru
Topics: 180
Posts: 432
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Vitamin K
39. A 63-year-old man is brought to the emergency
department 3 hours
after the acute onset of severe right-sided flank
pain. He has a
9-year history of gout. His blood pressure is 110/84
mm Hg, pulse is
78/min, and respirations are 16/min. Examination
shows normal bowel sounds
and no abdominal tenderness or masses. Urinalysis
shows 40
erythrocytes/hpf. Intravenous pyelography confirms a
right ureteral calculus.
Which of the following is the most likely underlying
mechanism of this
patient's urolithiasis?
A
) An increase in urinary pH
B
) Damage to the epithelial lining of the ureters
C
) Lack of inhibitors of crystal formation
D
) Presence of urease-splitting bacteria
E
) Urinary supersaturation with uric acid
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| Miradautas Vras
Forum Senior
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E. It's too obvious so i am having a little bit doubt but still E
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| nyimalay
Forum Elite
Topics: 9
Posts: 280
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I would go for C.
Ca oxalate stone. Commonest. 40 RBC. Due to lack of inhibitor of crystal formation.
Please post the correct answer if you have. Thanks.
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| dr.wad
Forum Senior
Topics: 3
Posts: 335
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A
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| guangyu
Forum Elite
Topics: 29
Posts: 308
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A
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| shahnaz.r
Forum Junior
Topics: 6
Posts: 72
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Ans: C 
Most common stone:calcium stones (75-85%).
Uric acid crystals can act as a nidus for calcium stone formation (25% of patient with calcium stone), independent of uric acid stone formation.
Prevalance for uric acid stone is 5-10%.
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| guangyu
Forum Elite
Topics: 29
Posts: 308
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increase urine ph lead to oxalate stone formation
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| shahnaz.r
Forum Junior
Topics: 6
Posts: 72
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sandra
please post the correct answer if u have
thnks
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| inkspot
Forum Guru
Topics: 26
Posts: 554
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i thought it was A . but. uric ACID in Basic medium wont stick and leak out into urine.
why not E? yes answer please.
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| Jcala
Forum Junior
Topics: 10
Posts: 44
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E
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| inkspot
Forum Guru
Topics: 26
Posts: 554
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again backing E:
the question does not say the stone was picked by x ray or usg. it was a uric acid stone for which they did an invasive test.
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