Question

A 31-year old female entered into the ER with left lower abdominal pain. She began to develop "renal colic" with nausea and vomitting. A CT was performed and revealed a 3cm "something" in her left ureter.

1. What was her most likely diagnosis?

2. What are these made up of?

3. What factors influence their formation?

4. What can be done to prevent reoccurrence?

Answer 1

Ans)1) A close up image of a calcium oxalate stone. Doctors will often use blood tests to check for increased levels of stone-forming substances in a person's body. An imaging test such as a plain film X-ray, a computed tomography (CT) scan, or ultrasound can help locate any significant stones in the urinary tract.

2) Renal stones made up of:

Not all kidney stones are made up of the same crystals. The different types of kidney stones include:

Calcium
Calcium stones are the most common. They’re often made of calcium oxalate (though they can consist of calcium phosphate or maleate). Eating fewer oxalate-rich foods can reduce your risk of developing this type of stone. High-oxalate foods include:

potato chips
peanuts
chocolate
beets
spinach
However, even though some kidney stones are made of calcium, getting enough calcium in your diet can prevent stones from forming.

Uric acid
This type of kidney stone is more common in men than in women. They can occur in people with gout or those going through chemotherapy.

This type of stone develops when urine is too acidic. A diet rich in purines can increase urine’s acidic level. Purine is a colorless substance in animal proteins, such as fish, shellfish, and meats.

Struvite
This type of stone is found mostly in women with urinary tract infections (UTIs). These stones can be large and cause urinary obstruction. They result from a kidney infection. Treating an underlying infection can prevent the development of struvite stones.

Cystine
Cystine stones are rare. They occur in both men and women who have the genetic disorder cystinuria. With this type of stone, cystine — an acid that occurs naturally in the body — leaks from the kidneys into the urine.

3) A history of kidney stones can increase your risk. So does a family history of kidney stones.

Other risk factors include:

• dehydration
• obesity
• a diet with high levels of protein, salt, or glucose hyperparathyroid condition gastric bypass surgery inflammatory bowel diseases that increase calcium absorption taking medications such as triamterene diuretics, antiseizure drugs, and calcium-based antacids.

4) Proper hydration is a key preventive measure.

Can be substituted with ginger ale, lemon-lime soda, and fruit juice for water to help increase fluid intake. If the stones are related to low citrate levels, citrate juices could help prevent the formation of stones.

- Eating oxalate-rich foods in moderation and reducing your intake of salt and animal proteins can also lower risk of kidney stones.