Urolithiasis 1

Xanthogranulomatous pyelonephritis can occur in kidneys damaged by calculi and is most often associated with infection caused by:

1. a. E coli
2. b. Staph epidermidis
3. c. Proteus spp
4. d. Klebsiella spp
5. e. Enterobacter

The most important factor in the formation of uric acid calculi is:

1. a. Concentration of uric acid in the urine
2. b. Volume of urine
3. c. Limited solubility of uric acid in acidic solutions
4. d. Excessive dietary intake of purines
5. e. Presence of symptomatic gout

Patients with an ileostomy are at increased risk of urinary tract calculi composed of:

1. a. Uric acid
2. b. Calcium oxalate
3. c. Cystine
4. d. Calcium phosphate
5. e. 2,8-hydroxyadenine

The commonest complication of treatment with D-penicillamine, limiting its use to cystine stone disease, is:

1. a. Leukoplakia
2. b. Gastrointestinal upset
3. c. Lowered seizure threshold
4. d. Sexual dysfunction
5. e. Allergic reaction with arthralgia, rash & nephrotic syndrome

All of the following bacteria are capable of producing urease and potentially causing infective stones EXCEPT:

1. a. E coli
2. b. Staph epidermidis
3. c. Proteus spp
4. d. Pseudomonas spp
5. e. Klebsiella spp

The actions of parathyroid hormone (PTH) on the kidney are to:

1. a. Increase calcium and phosphorus absorption
2. b. Decrease calcium and phosphorus absorption
3. c. Increase calcium and decrease phosphorus absorption
4. d. Increase phosphorus and decrease calcium absorption
5. e. Promote production of active Vitamin D

A patient with normal urinary tract anatomy and no past history of calculous disease who then develops Crohn's disease is at risk of urinary calculi of the following composition:

1. a. Calcium phosphate
2. b. Triple phosphate (struvite)
3. c. Calcium oxalate
4. d. Uric acid
5. e. Cystine

Indicated medical therapy for renal leak hypercalciuria is:

1. a. Oral citrates
2. b. Magnesium oxide or gluconate
3. c. Cellulose phosphate or neutral phosphate
4. d. Allopurinol
5. e. Thiazide diuretics

Stones may rarely form as a result of which antihypertensive medications:

1. a. Hydrochlorothiazide
2. b. Propranolol
3. c. Captopril
4. d. Triamterene
5. e. Practolol

What is the treatment of choice for a complete staghorn calculus with minimal dilatation of the collecting system?

1. a. Percutaneous nephrolithotomy
2. b. Open nephrolithotomy
3. c. Shockwave lithotripsy
4. d. Irrigation of the kidney with citrate solution
5. e. Simple nephrectomy