The document provides information on stone disease (urolithiasis). It summarizes that calcium oxalate is the most common type of kidney stone found in India, making up 86.1% of stones. Supersaturation of urine from dehydration is a key factor in stone formation. Extracorporeal shock wave lithotripsy (ESWL) is now the first-line treatment for the majority (80-85%) of stones, allowing them to be broken up without surgery. Complications of ESWL can include hematuria and incomplete stone fragmentation.
This document provides an overview of urolithiasis (kidney stones). It discusses the epidemiology, classification, pathogenesis, clinical features, investigations, treatment modalities, complications, and prevention of kidney stones. Treatment depends on the location and size of the stone and includes extracorporeal shock wave lithotripsy, percutaneous nephrolithotomy, ureteroscopy, and open surgery. The goal is to remove stones while minimizing complications such as infection, obstruction, and loss of renal function. Prevention focuses on adequate fluid intake, dietary modifications, and medical management for certain stone types.
Urinary calculi are composed of substances normally found in urine that precipitate out of solution to form stones. The most common types of stones found are calcium oxalate, calcium phosphate, uric acid, and cystine. Risk factors for stone formation include dehydration, diet, medical conditions, and anatomical abnormalities. Management involves dietary changes to reduce stone-forming substances in urine, increased fluid intake, and surgical procedures like ESWL or ureteroscopy for stone removal.
Renal stones are common, affecting around 10-15% of people in the US at some point. Calcium oxalate is the most common type of stone. Stones form due to supersaturation of minerals like calcium and oxalate in the urine. Investigations like ultrasound and CT are used to detect and characterize stones. Treatment depends on stone size and location, and may include medical expulsive therapy, shockwave lithotripsy, ureteroscopy, percutaneous nephrolithotomy, or open surgery. The goal is to remove stones while minimizing complications like bleeding or infection.
Urinary Stone Management [Dr. Edmond Wong]Edmond Wong
This document discusses the evaluation and treatment of kidney stones. It begins by outlining the typical workup, which includes imaging tests like CT scans, renal function tests, and metabolic workups of blood and urine. Various treatment options for kidney stones are then reviewed, including extracorporeal shockwave lithotripsy (ESWL), ureteroscopic lithotripsy (URSL), percutaneous nephrolithotomy (PCNL), and various surgical procedures. Risk factors, epidemiology, specific stone types and underlying factors are also discussed.
This document summarizes a presentation on renal stone disease. It discusses the anatomy of the kidneys and nephrons, stages of stone formation, types of stones including calcium oxalate and uric acid stones, investigations for stones, and medical and surgical management options. It notes that calcium oxalate is the most common stone type, occurring in over 75% of cases. Dietary and metabolic factors that can promote stone formation like hypercalciuria and hyperoxaluria are also outlined.
This document discusses the diagnosis and management of kidney stones (urolithiasis). It covers the epidemiology, types, diagnosis, and treatment options for kidney stones. For diagnosis, it recommends non-contrast CT scanning as the most sensitive test. For treatment, it describes medical expulsive therapy using drugs to help pass small stones, as well as minimally invasive procedures like ESWL, PNL, and ureteroscopy for larger stones. Factors like stone size, location, and composition are considered when selecting a treatment approach.
This document discusses the evaluation and workup of patients presenting with renal stones. It outlines the importance of obtaining a detailed history regarding lifestyle, diet, medical history and risk factors. A physical exam can reveal signs of renal colic or obstruction. Metabolic testing and stone analysis help determine the stone composition and underlying abnormalities. Radiological investigations including ultrasound, CT and occasionally IVP are used to identify stones and assess for complications like hydronephrosis. Proper evaluation guides management and treatment of kidney stone disease.
This document outlines the evaluation and management of urolithiasis by the Department of Urology at Govt Royapettah Hospital and Kilpauk Medical College in Chennai. It discusses the moderators, evaluation including history, examinations, imaging and laboratory tests. Management is covered including general measures, medical management, extracorporeal shock wave lithotripsy, endoscopic procedures like ureteroscopy and percutaneous nephrolithotomy, and open surgeries. Indications and complications of the different treatment methods are also provided.
This document provides an overview of urolithiasis (kidney stones). It discusses the epidemiology, classification, pathogenesis, clinical features, investigations, treatment modalities, complications, and prevention of kidney stones. Treatment depends on the location and size of the stone and includes extracorporeal shock wave lithotripsy, percutaneous nephrolithotomy, ureteroscopy, and open surgery. The goal is to remove stones while minimizing complications such as infection, obstruction, and loss of renal function. Prevention focuses on adequate fluid intake, dietary modifications, and medical management for certain stone types.
Urinary calculi are composed of substances normally found in urine that precipitate out of solution to form stones. The most common types of stones found are calcium oxalate, calcium phosphate, uric acid, and cystine. Risk factors for stone formation include dehydration, diet, medical conditions, and anatomical abnormalities. Management involves dietary changes to reduce stone-forming substances in urine, increased fluid intake, and surgical procedures like ESWL or ureteroscopy for stone removal.
Renal stones are common, affecting around 10-15% of people in the US at some point. Calcium oxalate is the most common type of stone. Stones form due to supersaturation of minerals like calcium and oxalate in the urine. Investigations like ultrasound and CT are used to detect and characterize stones. Treatment depends on stone size and location, and may include medical expulsive therapy, shockwave lithotripsy, ureteroscopy, percutaneous nephrolithotomy, or open surgery. The goal is to remove stones while minimizing complications like bleeding or infection.
Urinary Stone Management [Dr. Edmond Wong]Edmond Wong
This document discusses the evaluation and treatment of kidney stones. It begins by outlining the typical workup, which includes imaging tests like CT scans, renal function tests, and metabolic workups of blood and urine. Various treatment options for kidney stones are then reviewed, including extracorporeal shockwave lithotripsy (ESWL), ureteroscopic lithotripsy (URSL), percutaneous nephrolithotomy (PCNL), and various surgical procedures. Risk factors, epidemiology, specific stone types and underlying factors are also discussed.
This document summarizes a presentation on renal stone disease. It discusses the anatomy of the kidneys and nephrons, stages of stone formation, types of stones including calcium oxalate and uric acid stones, investigations for stones, and medical and surgical management options. It notes that calcium oxalate is the most common stone type, occurring in over 75% of cases. Dietary and metabolic factors that can promote stone formation like hypercalciuria and hyperoxaluria are also outlined.
This document discusses the diagnosis and management of kidney stones (urolithiasis). It covers the epidemiology, types, diagnosis, and treatment options for kidney stones. For diagnosis, it recommends non-contrast CT scanning as the most sensitive test. For treatment, it describes medical expulsive therapy using drugs to help pass small stones, as well as minimally invasive procedures like ESWL, PNL, and ureteroscopy for larger stones. Factors like stone size, location, and composition are considered when selecting a treatment approach.
This document discusses the evaluation and workup of patients presenting with renal stones. It outlines the importance of obtaining a detailed history regarding lifestyle, diet, medical history and risk factors. A physical exam can reveal signs of renal colic or obstruction. Metabolic testing and stone analysis help determine the stone composition and underlying abnormalities. Radiological investigations including ultrasound, CT and occasionally IVP are used to identify stones and assess for complications like hydronephrosis. Proper evaluation guides management and treatment of kidney stone disease.
This document outlines the evaluation and management of urolithiasis by the Department of Urology at Govt Royapettah Hospital and Kilpauk Medical College in Chennai. It discusses the moderators, evaluation including history, examinations, imaging and laboratory tests. Management is covered including general measures, medical management, extracorporeal shock wave lithotripsy, endoscopic procedures like ureteroscopy and percutaneous nephrolithotomy, and open surgeries. Indications and complications of the different treatment methods are also provided.
This document summarizes the medical management of renal calculi (kidney stones). It discusses risk factors, diagnostic evaluation including imaging and urine tests, conservative and pharmacological approaches, and surgical management options. The conservative approach involves increased fluid intake while pharmacological agents include thiazide diuretics, citrate, and allopurinol depending on the identified metabolic abnormality. Surgical interventions for stones include shock wave lithotripsy, ureteroscopy, and percutaneous nephrolithotomy.
This document discusses nephrolithiasis (kidney stones). It begins by providing background on the prevalence and costs of kidney stones. It then describes the types of stones (calcium, uric acid, struvite, cystine, drug-induced), risk factors, clinical presentation including renal colic, methods of diagnosis using imaging, and medical management focusing on pain control and increasing fluid intake to pass stones. It concludes by outlining principles of preventing recurrent stones through increasing urine volume and specific measures for preventing calcium stones, the most common type, which involve addressing hypercalciuria.
This document discusses urolithiasis, or kidney stones. It begins by introducing kidney stones as the third most common pathology after UTIs and prostate issues. It then covers the pathogenesis, risk factors, classifications, varieties, clinical features, evaluations, and treatments of kidney stones. Key points include that calcium stones make up 70-80% of cases, struvite and cystine stones are also common, risk factors include diet, fluid intake, family history, and medical conditions. Evaluations involve urinalysis, imaging like ultrasound or CT, and stone analysis. Treatments depend on stone location and size, with drainage for infected or obstructed cases.
- The document is a literature review on nephrolithiasis (kidney stones) that discusses the urinary system, types of kidney stones, stone formation and morphology, manifestations of stones such as pain and infection, and treatment methods.
- The most common type of kidney stone is calcium stones, which constitute 80-90% of all renal stones. Other types include uric acid, struvite, and cystine stones.
- Symptoms of kidney stones include flank pain from stones moving through the ureter, as well as hematuria, urinary tract infections, and potentially loss of kidney function in severe cases. Computed tomography and ultrasound are used to diagnose stones.
This document provides a literature review on nephrolithiasis (kidney stones). It discusses the urinary system and how kidney stones form. The most common types of kidney stones are calcium-based, including calcium oxalate and calcium phosphate stones. Stones can cause symptoms when they block the ureters or kidneys. Complications include infection, obstruction, and loss of kidney function. The pathogenesis of stones involves urine becoming supersaturated due to excessive levels of stone-forming compounds like calcium, oxalate, and phosphate. This can lead to crystal formation and growth into kidney stones.
Common disorder with an annual incidence of 0.1% to 0.5%.
The peak age at onset is 20 to 30 years
Men > Women ( until 50s )
Wide geographic variations exist, due to differences in diet and water composition, as well as ambient and sunlight exposure. 5-9% in Europe 20% in Saudi Arabia
RENAL STONES & STONES IN PREGNANCY .pptxBipul Thakur
This document discusses the management of kidney stones during pregnancy. It notes that kidney stones are a common non-obstetric cause of hospitalization during pregnancy. While conservative management is preferred, around 1/3 of patients require surgical intervention due to uncontrolled pain or signs of obstruction/infection. Accepted surgical treatments include ureteral stenting, percutaneous nephrostomy drainage, and ureteroscopy during the second trimester. However, these options all carry risks of complications from repeated procedures or radiation exposure and are generally deferred until after delivery when possible.
This document summarizes urolithiasis (kidney stone disease). It discusses the epidemiology, risk factors, types of stones, clinical presentation, investigations, treatment options, and prevention strategies. The peak age for stones is 20-40 years. Risk factors include excess calcium, oxalate, or uric acid in the urine. Common stone types are calcium oxalate, uric acid, cystine, and struvite. Clinical symptoms depend on the location of the stone and include flank pain, hematuria, and obstruction. Investigations include imaging like CT, IVU, ultrasound and metabolic workup. Treatment involves medical expulsion therapy, ESWL, ureteroscopy, percutaneous neph
The document discusses urinary tract stones (calculi) including their formation, types, symptoms, diagnosis, and treatment. Key points:
- Stones form when urinary concentrations of minerals like calcium, oxalate, and uric acid increase.
- Symptoms include sharp pain (renal colic) radiating from the back to the groin as stones pass through the urinary tract.
- Diagnosis involves imaging tests like CT scans, X-rays, and ultrasounds to detect radiopaque stones.
- Treatment depends on stone size but may include shock wave lithotripsy, ureteroscopy, or open surgery to remove stones. Recurrence rates after treatment remain high.
This document discusses the classification, pathophysiology, presentation, imaging, laboratory evaluation and treatment of nephrolithiasis in pediatric patients. The main types of stones include calcium, uric acid, cystine and struvite. Important risk factors are hypercalciuria, hypocitraturia, hyperoxaluria and low urine volume. Treatment depends on stone size and location but may include extracorporeal shock wave lithotripsy, ureteroscopy, percutaneous nephrolithotomy or open surgery. Diet and medical management target the underlying metabolic abnormalities promoting stone formation.
This document discusses kidney stones (urolithiasis), including:
- Types of stones are classified by composition, x-ray appearance, or size and shape. Common types include calcium oxalate, uric acid, struvite, and cystine stones.
- Risk factors for stone formation include age, sex, family history, diet, fluid intake, medical conditions, and anatomical abnormalities.
- Evaluation of stone patients includes analyzing the stone composition and performing metabolic testing to identify predisposing factors.
- Treatment options depend on the stone characteristics and include watchful waiting, extracorporeal shockwave lithotripsy (ESWL), ureteroscopy, percutaneous nephrolith
This document provides information on urinary tract stones (urolithiasis), including:
- The types and locations of stones including nephrolithiasis, ureterolithiasis, and cystolithiasis.
- Common causes or risk factors for stone formation including diet, dehydration, infection, and genetic factors.
- Clinical features associated with stones in the kidneys, ureters, and bladder.
- Imaging techniques used to detect stones such as radiography, intravenous urography, CT, and ultrasound.
- Treatment approaches including medical expulsive therapy, shockwave lithotripsy, ureteroscopy, and open surgery.
This document provides an overview of preventing renal stones through medical management. It discusses the epidemiology of kidney stones, risk factors, pathophysiology, and principles of prevention. The key points are:
- Kidney stones affect around 8.5% of the population and are more common in white males over age 30. Risk factors include family history, diet, hydration, and medical conditions.
- Stones are usually composed of calcium oxalate, calcium phosphate, struvite, or uric acid. Medical management focuses on preventing supersaturation by increasing fluid intake and treating conditions like hypercalciuria.
- Treatment options for different stone types include thiazide diuretics for hypercal
urolithasis.pptx for medical purposes...GokulnathMbbs
This document discusses urinary tract stones (urolithiasis). It defines different types of stones including nephrolithiasis, ureterolithiasis, and cystolithiasis. It covers the etiology of stone formation including dietary factors, dehydration, infection, and genetic conditions. Types of stones like calcium oxalate, struvite, cystine and uric acid are described. Clinical features, investigations, and management options for kidney stones, ureteric stones and bladder stones are summarized. Treatment includes conservative measures, shock wave lithotripsy, ureteroscopy, percutaneous nephrolithotomy and open surgery.
This document discusses kidney stones (urolithiasis), including their prevalence, risk factors, locations, and management techniques. Some key points:
- Kidney stones have a worldwide prevalence of 12% and affect 12% of the Indian population. Risk factors include diet, climate, metabolic disorders, and infections.
- Management depends on stone size, composition, and location. Minimally invasive techniques like extracorporeal shock wave lithotripsy (ESWL), percutaneous nephrolithotomy (PCNL), and ureteroscopic stone removal are often used to treat stones.
- Larger or more complex stones may require open or laparoscopic surgery. The goal is maximal stone clearance
Kidney Stone By Dr ANIL KUMAR, Associate Professor( AIIMS-Patna)Anil Kumar
The document discusses renal calculi (kidney stones). It provides details on the anatomy of the kidney, causes of renal stones including risk factors, types of stones, clinical presentation, investigations and management. The main types of stones are calcium oxalate, phosphate, uric acid, cystine, and xanthine stones. Investigations include urine analysis, imaging like ultrasound, CT and IVU. Management depends on stone size and includes conservative measures, extracorporeal shock wave lithotripsy (ESWL), percutaneous nephrolithotomy (PCNL), and open surgery.
This document discusses renal calculi (kidney stones). It defines renal calculi and reviews the anatomy and physiology of the renal system. It examines the etiology, risk factors, and pathogenesis of renal calculi. It also describes the clinical manifestations, diagnostic studies, medical and surgical management, nursing management including nursing diagnoses, and prevention of renal calculi.
This document discusses the evaluation of renal stones in children. It begins with a case scenario of a 15-year-old boy presenting with left flank pain and hematuria. It then provides introductions to kidney stones, urolithiasis, nephrolithiasis, and nephrocalcinosis. The document discusses the epidemiology, incidence, stone formation process, types of kidney stones including calcium, uric acid, struvite and cystine stones. It outlines risk factors, pathophysiology, approach to diagnosis including detailed history, clinical examination, investigations such as imaging tests, urine analysis and blood tests. It provides details on imaging findings, normal urine constituent levels, the method of stone analysis and algorithms
This document discusses kidney stones (nephrolithiasis) and renal tubular acidosis (RTA). It begins by listing the professors and assistant professors in the Department of Urology at Govt Royapettah Hospital and Kilpauk Medical College in Chennai. It then provides information on the causes, types, symptoms, diagnosis and treatment of kidney stones. It also describes the types and treatment of RTA, including the use of alkali replacement therapies. The document contains detailed information on lithotripsy procedures for breaking up stones, such as extracorporeal shock wave lithotripsy.
Dr. Sangeeta Khyalia discusses the central dogma of biology and the processes of transcription and translation. Transcription is the synthesis of RNA using DNA as a template, catalyzed by the enzyme RNA polymerase. It involves initiation, elongation, and termination. Eukaryotic transcription differs from prokaryotic transcription in initiation and processing of pre-mRNA. The document provides details on RNA polymerases, promoters, inhibitors of transcription, and post-transcriptional modifications of pre-mRNA in eukaryotes like splicing and polyadenylation.
This study aims to assess the prevalence of EGFR mutations in patients with advanced non-small cell lung carcinoma (NSCLC) at a tertiary care center in Rajasthan, India. The study will collect tissue samples from 90 NSCLC patients and test for EGFR mutations using real-time PCR. Previous studies have found EGFR mutation rates ranging from 20-37.9% in Indian NSCLC patients. Detecting EGFR mutations could help predict response to EGFR tyrosine kinase inhibitors and improve patient outcomes. This would be the first study to report the prevalence of EGFR mutations in lung cancer patients in Rajasthan.
This document summarizes the medical management of renal calculi (kidney stones). It discusses risk factors, diagnostic evaluation including imaging and urine tests, conservative and pharmacological approaches, and surgical management options. The conservative approach involves increased fluid intake while pharmacological agents include thiazide diuretics, citrate, and allopurinol depending on the identified metabolic abnormality. Surgical interventions for stones include shock wave lithotripsy, ureteroscopy, and percutaneous nephrolithotomy.
This document discusses nephrolithiasis (kidney stones). It begins by providing background on the prevalence and costs of kidney stones. It then describes the types of stones (calcium, uric acid, struvite, cystine, drug-induced), risk factors, clinical presentation including renal colic, methods of diagnosis using imaging, and medical management focusing on pain control and increasing fluid intake to pass stones. It concludes by outlining principles of preventing recurrent stones through increasing urine volume and specific measures for preventing calcium stones, the most common type, which involve addressing hypercalciuria.
This document discusses urolithiasis, or kidney stones. It begins by introducing kidney stones as the third most common pathology after UTIs and prostate issues. It then covers the pathogenesis, risk factors, classifications, varieties, clinical features, evaluations, and treatments of kidney stones. Key points include that calcium stones make up 70-80% of cases, struvite and cystine stones are also common, risk factors include diet, fluid intake, family history, and medical conditions. Evaluations involve urinalysis, imaging like ultrasound or CT, and stone analysis. Treatments depend on stone location and size, with drainage for infected or obstructed cases.
- The document is a literature review on nephrolithiasis (kidney stones) that discusses the urinary system, types of kidney stones, stone formation and morphology, manifestations of stones such as pain and infection, and treatment methods.
- The most common type of kidney stone is calcium stones, which constitute 80-90% of all renal stones. Other types include uric acid, struvite, and cystine stones.
- Symptoms of kidney stones include flank pain from stones moving through the ureter, as well as hematuria, urinary tract infections, and potentially loss of kidney function in severe cases. Computed tomography and ultrasound are used to diagnose stones.
This document provides a literature review on nephrolithiasis (kidney stones). It discusses the urinary system and how kidney stones form. The most common types of kidney stones are calcium-based, including calcium oxalate and calcium phosphate stones. Stones can cause symptoms when they block the ureters or kidneys. Complications include infection, obstruction, and loss of kidney function. The pathogenesis of stones involves urine becoming supersaturated due to excessive levels of stone-forming compounds like calcium, oxalate, and phosphate. This can lead to crystal formation and growth into kidney stones.
Common disorder with an annual incidence of 0.1% to 0.5%.
The peak age at onset is 20 to 30 years
Men > Women ( until 50s )
Wide geographic variations exist, due to differences in diet and water composition, as well as ambient and sunlight exposure. 5-9% in Europe 20% in Saudi Arabia
RENAL STONES & STONES IN PREGNANCY .pptxBipul Thakur
This document discusses the management of kidney stones during pregnancy. It notes that kidney stones are a common non-obstetric cause of hospitalization during pregnancy. While conservative management is preferred, around 1/3 of patients require surgical intervention due to uncontrolled pain or signs of obstruction/infection. Accepted surgical treatments include ureteral stenting, percutaneous nephrostomy drainage, and ureteroscopy during the second trimester. However, these options all carry risks of complications from repeated procedures or radiation exposure and are generally deferred until after delivery when possible.
This document summarizes urolithiasis (kidney stone disease). It discusses the epidemiology, risk factors, types of stones, clinical presentation, investigations, treatment options, and prevention strategies. The peak age for stones is 20-40 years. Risk factors include excess calcium, oxalate, or uric acid in the urine. Common stone types are calcium oxalate, uric acid, cystine, and struvite. Clinical symptoms depend on the location of the stone and include flank pain, hematuria, and obstruction. Investigations include imaging like CT, IVU, ultrasound and metabolic workup. Treatment involves medical expulsion therapy, ESWL, ureteroscopy, percutaneous neph
The document discusses urinary tract stones (calculi) including their formation, types, symptoms, diagnosis, and treatment. Key points:
- Stones form when urinary concentrations of minerals like calcium, oxalate, and uric acid increase.
- Symptoms include sharp pain (renal colic) radiating from the back to the groin as stones pass through the urinary tract.
- Diagnosis involves imaging tests like CT scans, X-rays, and ultrasounds to detect radiopaque stones.
- Treatment depends on stone size but may include shock wave lithotripsy, ureteroscopy, or open surgery to remove stones. Recurrence rates after treatment remain high.
This document discusses the classification, pathophysiology, presentation, imaging, laboratory evaluation and treatment of nephrolithiasis in pediatric patients. The main types of stones include calcium, uric acid, cystine and struvite. Important risk factors are hypercalciuria, hypocitraturia, hyperoxaluria and low urine volume. Treatment depends on stone size and location but may include extracorporeal shock wave lithotripsy, ureteroscopy, percutaneous nephrolithotomy or open surgery. Diet and medical management target the underlying metabolic abnormalities promoting stone formation.
This document discusses kidney stones (urolithiasis), including:
- Types of stones are classified by composition, x-ray appearance, or size and shape. Common types include calcium oxalate, uric acid, struvite, and cystine stones.
- Risk factors for stone formation include age, sex, family history, diet, fluid intake, medical conditions, and anatomical abnormalities.
- Evaluation of stone patients includes analyzing the stone composition and performing metabolic testing to identify predisposing factors.
- Treatment options depend on the stone characteristics and include watchful waiting, extracorporeal shockwave lithotripsy (ESWL), ureteroscopy, percutaneous nephrolith
This document provides information on urinary tract stones (urolithiasis), including:
- The types and locations of stones including nephrolithiasis, ureterolithiasis, and cystolithiasis.
- Common causes or risk factors for stone formation including diet, dehydration, infection, and genetic factors.
- Clinical features associated with stones in the kidneys, ureters, and bladder.
- Imaging techniques used to detect stones such as radiography, intravenous urography, CT, and ultrasound.
- Treatment approaches including medical expulsive therapy, shockwave lithotripsy, ureteroscopy, and open surgery.
This document provides an overview of preventing renal stones through medical management. It discusses the epidemiology of kidney stones, risk factors, pathophysiology, and principles of prevention. The key points are:
- Kidney stones affect around 8.5% of the population and are more common in white males over age 30. Risk factors include family history, diet, hydration, and medical conditions.
- Stones are usually composed of calcium oxalate, calcium phosphate, struvite, or uric acid. Medical management focuses on preventing supersaturation by increasing fluid intake and treating conditions like hypercalciuria.
- Treatment options for different stone types include thiazide diuretics for hypercal
urolithasis.pptx for medical purposes...GokulnathMbbs
This document discusses urinary tract stones (urolithiasis). It defines different types of stones including nephrolithiasis, ureterolithiasis, and cystolithiasis. It covers the etiology of stone formation including dietary factors, dehydration, infection, and genetic conditions. Types of stones like calcium oxalate, struvite, cystine and uric acid are described. Clinical features, investigations, and management options for kidney stones, ureteric stones and bladder stones are summarized. Treatment includes conservative measures, shock wave lithotripsy, ureteroscopy, percutaneous nephrolithotomy and open surgery.
This document discusses kidney stones (urolithiasis), including their prevalence, risk factors, locations, and management techniques. Some key points:
- Kidney stones have a worldwide prevalence of 12% and affect 12% of the Indian population. Risk factors include diet, climate, metabolic disorders, and infections.
- Management depends on stone size, composition, and location. Minimally invasive techniques like extracorporeal shock wave lithotripsy (ESWL), percutaneous nephrolithotomy (PCNL), and ureteroscopic stone removal are often used to treat stones.
- Larger or more complex stones may require open or laparoscopic surgery. The goal is maximal stone clearance
Kidney Stone By Dr ANIL KUMAR, Associate Professor( AIIMS-Patna)Anil Kumar
The document discusses renal calculi (kidney stones). It provides details on the anatomy of the kidney, causes of renal stones including risk factors, types of stones, clinical presentation, investigations and management. The main types of stones are calcium oxalate, phosphate, uric acid, cystine, and xanthine stones. Investigations include urine analysis, imaging like ultrasound, CT and IVU. Management depends on stone size and includes conservative measures, extracorporeal shock wave lithotripsy (ESWL), percutaneous nephrolithotomy (PCNL), and open surgery.
This document discusses renal calculi (kidney stones). It defines renal calculi and reviews the anatomy and physiology of the renal system. It examines the etiology, risk factors, and pathogenesis of renal calculi. It also describes the clinical manifestations, diagnostic studies, medical and surgical management, nursing management including nursing diagnoses, and prevention of renal calculi.
This document discusses the evaluation of renal stones in children. It begins with a case scenario of a 15-year-old boy presenting with left flank pain and hematuria. It then provides introductions to kidney stones, urolithiasis, nephrolithiasis, and nephrocalcinosis. The document discusses the epidemiology, incidence, stone formation process, types of kidney stones including calcium, uric acid, struvite and cystine stones. It outlines risk factors, pathophysiology, approach to diagnosis including detailed history, clinical examination, investigations such as imaging tests, urine analysis and blood tests. It provides details on imaging findings, normal urine constituent levels, the method of stone analysis and algorithms
This document discusses kidney stones (nephrolithiasis) and renal tubular acidosis (RTA). It begins by listing the professors and assistant professors in the Department of Urology at Govt Royapettah Hospital and Kilpauk Medical College in Chennai. It then provides information on the causes, types, symptoms, diagnosis and treatment of kidney stones. It also describes the types and treatment of RTA, including the use of alkali replacement therapies. The document contains detailed information on lithotripsy procedures for breaking up stones, such as extracorporeal shock wave lithotripsy.
Dr. Sangeeta Khyalia discusses the central dogma of biology and the processes of transcription and translation. Transcription is the synthesis of RNA using DNA as a template, catalyzed by the enzyme RNA polymerase. It involves initiation, elongation, and termination. Eukaryotic transcription differs from prokaryotic transcription in initiation and processing of pre-mRNA. The document provides details on RNA polymerases, promoters, inhibitors of transcription, and post-transcriptional modifications of pre-mRNA in eukaryotes like splicing and polyadenylation.
This study aims to assess the prevalence of EGFR mutations in patients with advanced non-small cell lung carcinoma (NSCLC) at a tertiary care center in Rajasthan, India. The study will collect tissue samples from 90 NSCLC patients and test for EGFR mutations using real-time PCR. Previous studies have found EGFR mutation rates ranging from 20-37.9% in Indian NSCLC patients. Detecting EGFR mutations could help predict response to EGFR tyrosine kinase inhibitors and improve patient outcomes. This would be the first study to report the prevalence of EGFR mutations in lung cancer patients in Rajasthan.
The document summarizes key aspects of de novo fatty acid synthesis. It occurs in the cytosol of liver, adipose tissue, and lactating mammary glands. Acetyl-CoA is the starting material, which is transported from mitochondria to cytosol via citrate. The fatty acid synthase complex contains multiple enzymatic domains that catalyze the sequential additions of two-carbon units from malonyl-CoA to produce palmitate (C16). The process requires NADPH and ATP as cofactors. Fatty acid synthesis is regulated by enzymes, metabolites, hormones, and diet.
This document provides an overview of carbohydrate metabolism. It discusses the various pathways involved including glycolysis, the citric acid cycle, gluconeogenesis, glycogen metabolism, the hexose monophosphate shunt, and uronic acid pathway. For each pathway, it describes the key reactions, regulation, enzymes involved, energy production, and some clinical significance. The document is a comprehensive review of carbohydrate metabolism from a biochemical perspective.
Enzymes are protein catalysts that speed up biochemical reactions without being consumed. They achieve high specificity by catalyzing particular substrate-product reactions. Many enzymes require cofactors like B vitamins to function, acting as carriers to transfer reactive groups from one substrate to another. The systematic enzyme nomenclature system provides unambiguous names related to substrates, reactions, and four-digit EC numbers for classification.
Lipid associated disorders include obesity, metabolic syndrome, fatty liver, atherosclerosis, and coronary heart diseases. They can be caused by nutritional imbalances, lifestyle habits, genetic abnormalities, or secondary to other diseases. Disorders are classified based on abnormal lipid concentrations, including hyperlipoproteinemias which have increased lipids and hypolipoproteinemias which have decreased lipids. Fatty liver disease occurs when excess lipids accumulate in liver cells, known as steatosis, and can progress to inflammation and fibrosis and even cirrhosis with repeated damage over time.
This document provides an overview of carbohydrate chemistry and functions. It defines carbohydrates as polyhydroxy aldehydes, ketones, or derivatives. Carbohydrates are classified based on number of saccharide units into monosaccharides, disaccharides, oligosaccharides, and polysaccharides. Key monosaccharides like glucose and fructose are discussed in detail, along with their structural properties. Disaccharides, oligosaccharides, polysaccharides, and biologically important carbohydrates like mucoproteins are also introduced. The document emphasizes the structural features and roles of carbohydrates in the human body.
How to Control Your Asthma Tips by gokuldas hospital.Gokuldas Hospital
Respiratory issues like asthma are the most sensitive issue that is affecting millions worldwide. It hampers the daily activities leaving the body tired and breathless.
The key to a good grip on asthma is proper knowledge and management strategies. Understanding the patient-specific symptoms and carving out an effective treatment likewise is the best way to keep asthma under control.
low birth weight presentation. Low birth weight (LBW) infant is defined as the one whose birth weight is less than 2500g irrespective of their gestational age. Premature birth and low birth weight(LBW) is still a serious problem in newborn. Causing high morbidity and mortality rate worldwide. The nursing care provide to low birth weight babies is crucial in promoting their overall health and development. Through careful assessment, diagnosis,, planning, and evaluation plays a vital role in ensuring these vulnerable infants receive the specialize care they need. In India every third of the infant weight less than 2500g.
Birth period, socioeconomical status, nutritional and intrauterine environment are the factors influencing low birth weight
5-hydroxytryptamine or 5-HT or Serotonin is a neurotransmitter that serves a range of roles in the human body. It is sometimes referred to as the happy chemical since it promotes overall well-being and happiness.
It is mostly found in the brain, intestines, and blood platelets.
5-HT is utilised to transport messages between nerve cells, is known to be involved in smooth muscle contraction, and adds to overall well-being and pleasure, among other benefits. 5-HT regulates the body's sleep-wake cycles and internal clock by acting as a precursor to melatonin.
It is hypothesised to regulate hunger, emotions, motor, cognitive, and autonomic processes.
Nano-gold for Cancer Therapy chemistry investigatory projectSIVAVINAYAKPK
chemistry investigatory project
The development of nanogold-based cancer therapy could revolutionize oncology by providing a more targeted, less invasive treatment option. This project contributes to the growing body of research aimed at harnessing nanotechnology for medical applications, paving the way for future clinical trials and potential commercial applications.
Cancer remains one of the leading causes of death worldwide, prompting the need for innovative treatment methods. Nanotechnology offers promising new approaches, including the use of gold nanoparticles (nanogold) for targeted cancer therapy. Nanogold particles possess unique physical and chemical properties that make them suitable for drug delivery, imaging, and photothermal therapy.
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Co-Chairs, Val J. Lowe, MD, and Cyrus A. Raji, MD, PhD, prepared useful Practice Aids pertaining to Alzheimer’s disease for this CME/AAPA activity titled “Alzheimer’s Disease Case Conference: Gearing Up for the Expanding Role of Neuroradiology in Diagnosis and Treatment.” For the full presentation, downloadable Practice Aids, and complete CME/AAPA information, and to apply for credit, please visit us at https://bit.ly/3PvVY25. CME/AAPA credit will be available until June 28, 2025.
8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptxHolistified Wellness
We’re talking about Vedic Meditation, a form of meditation that has been around for at least 5,000 years. Back then, the people who lived in the Indus Valley, now known as India and Pakistan, practised meditation as a fundamental part of daily life. This knowledge that has given us yoga and Ayurveda, was known as Veda, hence the name Vedic. And though there are some written records, the practice has been passed down verbally from generation to generation.
8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptx
stone.pptx
1. STONE DISEASE
( Brief Overview )
Dr. Sunil Shroff, MS, FRCS (UK), D.Urol (Lond.),
Professor & HOD, Dept. of Urology,
Sri Ramachandra Medical College & Research Institution
Consultant Urologist & Renal Transplant Surgeon,
Sri Ramachandra Hospital, Porur, Madras.
2. COMPARATIVE INCIDENCES OF FORMS OF URINARY LITHIASIS
Stone analysis in Percentage
Form of Lithiasis India USA Japan UK
Pure Calcium Oxalate 86.1 33 17.4 39.4
Mixed Calcium Oxalate and 4.9 34 50.8 20.2
Phosphate
Magnesium Ammonium 2.7 15 17.4 15.4
Phosphate (Struvite )
Uric Acid 1.2 8.0 4.4 8.0
Cystine 0.4 3.0 1.0 2.8
3. Cause of Stone Disease
• Supersaturation of urine is the key to stone formation
• Intermittent supersaturation - Dehydration
• Crystal aggregation
• Anatomic Abnormailities – PUJ , MSK
• Bacterial Infection
• Defects in transport of Calcium and Oxalate by Renal
epithelia
E.Coli infection increases matrix content in urine . Proteus makes urine alkaline
4. Inhibitors & Promoters of Stone Formation in Urine
INHIBITORS
Inhibits crystal Growth -
• Citrate – complexes with Ca
• Magnesium – complexes with
oxalates
• Pyrphosphate - complexes
with Ca
• Zinc
Inhibits crystal Aggregation
• Glycosaminoglycans
• Nephrocalcin
• Tamm- Horsfall Protein
PROMOTERS
• Bacterial Infection
• Matrix
• Anatomic Abnormalities – PUJ
obst., MSK
• Altered Ca and oxalate transport
in renal epithelia
• Prolonged immobilisation
• Increased uric acid levels I.e
taking increased purine subs–
promotes crystalisation of Ca and
oxalate
• ?? Nanobacteria – seen in 97% of
renal stones
5. SOME DISEASES ASSOCIATED WITH
HYPERCALCAEMIA & HYPERCALCIURIA
Hyperparathyroidism Leukemia
Sarcoidosis Lymphoma
Multiple myeloma Myxedema
Hyperthyroidism Adrenal Insufficiency
Metastatic Malig. Neoplasm's Vit. D Intoxication
7. Uncommon Stones
XANTHINE STONES
– (Autosomal Recessive . Def of Xanthine Oxidase leading to Xanthinuria)
DIHYDROXYADENINE STONE
– ( Def. of enzyme adenine phospo ribosyl transferase )
SlLICATE STONES
– Rare in humans ( excess intake of Antacid with Mg Trisilicate. Mostly in
cattle due to ingestion of Sand )
MATRIX
- Infection by Proteus - Radiolucent (all calculi have some amt ( 3%) of matrix
but matrix calculus has 65% Matrix content in calculi)
8. Uncommon Stones
TRIAMTERENE
– Anti-hypertensive used with hydroclorothiazide – spare Potassium.
Mostly found as a nucleus in Ca oxalate or uric acid calculus
Indinavir Stones
- Drug to treat AIDS (4 to13%)
Ephedrine or Guifenesin
– Cough medicine - Radiolucent
10. DD of Radiolucent filling defect on IVU in Ureter or
Kidney
Must Know
• Uric Acid Calculus
• Matrix Calculus
• Sloughed Papilla
• Blood Clots
• TCC
• Renal Cysts
• Vascular Lesions
Know For Brownie Points
• Xanthine Calculus
• Hydroxyadenine Calculus
• Ephederine Calculus
• Infection due to gas forming
Org.
• Fungal Ball
• Tuberculoma
• Malacoplakia
• Hypertrophied Papilla
• Renal pseudo-tumour
11. OXALATE (CALCIUM OXALATE)
• ALSO CALLED MULBERRY STONE
• COVERED WITH SHARP PROJECTIONS
• SHARP MAKES KIDNEY BLEED (HAEMATURIA)
• VERY HARD
• RADIO - OPAQUE
Under microscope looks like Hourglass or Dumbbell shape if monohydrate and
Like an Envelope if Dihydrate
12. PHOSPHATE STONE
• USUALLY CALCIUM PHOSPHATE
• SOMETIMES CALCIUM MAGNESIUM AMMONIUM
PHOSPHATE OR TRIPLE PHOSPHATE
• SMOOTH MINIMUM SYMPTOMS
• DIRTY WHITE
• RADIO - OPAQUE
Calcium Phosphate also called ‘Brushite’ appears like Needle shape under
microscope
13. PHOSPHATE STONES
IN ALKALINE URINE
ENLARGES RAPIDLY
TAKE SHAPE OF CALYCES
STAGHORN
Struvite can form Stag-horn and appear like coffin lid under microscope
14. CALCIUM PHOSPHATE STONES
• Hyperparathyroidism Ca P
• Renal Tubular Acidosis K CO2
• Medullary Sponge Kidney -
PTH Hormone Promotes renal production of 1-25-dihyroxycholecalciferol – active Vit.D and also
increases absorption of Calcium and decreases Phosphorus absorption from Kidneys
15. URIC ACID & URATE STONE
• HARD & SMOOTH
• MULTIPLE
• YELLOW OR RED-BROWN
• RADIO - LUCENT (USE ULTRASOUND)
Under microscope appear like irregular plates or rosettes
pKa of uric acid 5.75 – at this pH 50% of uric acid insoluble.
If pH falls further - uric acid more insoluble
16. CYSTINE STONE
• AUTOSOMAL RECESIVE DISORDER
• USUALLY IN YOUNG GIRLS
• DUE TO CYSTINURIA -
• CYSTINE NOT ABSORBED BY TUBULES
• MULTIPLE
• SOFT OR HARD – can form stag-horns
• PINK OR YELLOW
• RADIO-OPAQUE
Under microscope appears like hexagonal or benezene
ring – ask for first morning sample
17. CYSTINE STONE - Management
• High Fluid Intake and Alkalanise Urine – dissolve most of
the smaller cystine stones
• D-Pencillamine or MPG (Mercaptopropionylglycine) binds to
cystine that is soluble in urine
• Side effects of Pencillamine restricts it use – Allergic
rashes, GI problems- Nausea, Vomiting, Diarrhoea
• MPG better tolerated
• Large obstructive stones – Surgery required first
Cyanide Nitroprusside Calorimeteric Test for detecting Cystinuria. If positive do
amino acid chromatography
pKa of cystine is 8.3, hence alkalinisisation above pH7.5 helps to dissolve the stones
18. Surgical Conditions and Stone Disease
• Regional ileitis and Ileal Bypass Surgery for eg
Obesity can lead to increase oxalate absorption
and stone ds
• ileostomies - In Chr. Diarrhoea with– Bicabonate
loss – systemic acidosis and acidic urine –
increases risk of Uric Acid stones
19. HISTORY
A. IS PATIENT DRINKING ENOUGH ?
B. PROFESSION
C. ENQUIRE ABOUT UTI STONES
D. FAMILY HISTORY
E. LONG ILLNESS BEDRIDDEN STONES
20. MANAGEMENT OF STONES
HISTORY :
A. FIND OUT IF DRINKING ENOUGH LIQUIDS
(NOT DRINKING ENOUGH IMPORTANT CAUSE
OF STONE FORMATION & GROWTH)
Urinary supersaturation of salts in concentrated urine
Atleast drink 3 lits to avoid stone formation
21. HISTORY (Cont...)
B. ASK ABOUT THEIR PROFESSION
DEHYDRATION STONES CAN FORM e.g.
• MARATHON NEAR A FURNACE,
• BRICK - LAYER, LABOURERS & WEAVERS
• TRUCK & BUS DRIVERS
22. C. ENQUIRE ABOUT UTI STONES
D. FAMILY HISTORY
E. LONG ILLNESS BEDRIDDEN STONES
HISTORY (Cont...)
Zero Gravity state – astronauts on long space flights more prone to
stones
23. CLINICAL FEATURES
1. PAIN IN 75 % OF THE CASES
“RENAL COLIC” IF SEVERE AND ACUTE
A) KIDNEY STONE
FIXED PAIN IN THE LOIN
B) URETERIC STONE
PAIN RADIATES LOIN TO GROIN
Both Stomach & Kidney supplied by celiac ganglion hence Nausea & vomiting common in
renal colic
24. CLINICAL FEATURES (Contd....)
2) HAEMATURIA
• CAN BE FRANK
• OR ONLY FOUND ON DIP - STICK OR LAB.
3) PYURIA - IF INFECTION CAN HAVE PUS IN URINE
25. ON EXAMINATION
1. ACUTE PRESENTATION
• ABDOMEN TENSE AND RIGID
• TENDERNESS PRESENT IN THE LOIN
2. IN ROUTINE PRESENTATION
• NO FINDINGS IN ABDOMEN
26. INVESTIGATIONS
1. FULL BLOOD COUNT TO CHECK FOR
ANAEMIA IF GOING FOR SURGERY
2. SERUM ELECTROLYTES PLUS UREA /
CREATININE / CALCIUM / URIC ACID /
PHOSPHATE
29. INVESTIGATIONS
IVU OR IVP (INTRA VENOUS UROGRAM)
• Not Mandatory
• 1in 40,000 patients die due to anaphylactic reaction to
contrast
• Useful for radio-lucent stones & to detect
Congenital Anomalies in Urinary tracts
30. INVESTIGATIONS (Cont...)
7. CT –
TO LOOK AT UNUSUAL ANATOMY OF THE KIDNEY
To differentiate cause of acute colic – stone or anuria
Suspected due to stone disease
8. DMSA OR DTPA OR MAG3 RENOGRAM - TO STUDY
FUNCTION OF EACH KIDNEY.
31. Bilateral Ureteric Calculus in a patient presenting with Anuria
Helical or Spiral CT provides 3D reconstruction. Helical refers to path the X ray follows on
Gantry. These are rapidly performed and do not require contrast agents for reconstruction.
32. MANAGEMENT OF UROLITHIASIS
• Non-invasive approach to urinary calculas-
HALLMARK of last 20 yrs.
• Lithotripters –
1.Extra Corporeal Shock wave
2.Intra Corporeal
• Better fiber optics – Miniturisation of Telescopes
• Accessories - Innovative variety
33. Modern Management of Urolithiasis
• ESWL
• Ureterorenoscopy
• Percutaneous Nephrolithotomy
• Laparoscopic Approach to stones
Open Ureterolithotomy, Pyelolithotomy or Nephropyelolithotomy is required in less
than 1 to 2% of modern stone management
34. TREATMENT (IDEALLY)
MAJORITY : 80 TO 85 % of all stones can be treated by -
EXTRA - CORPOREAL SHOCK WAVE LITHOTRIPSY (ESWL)
MINORITY : 15 TO 20 % SHOULD NEED MINIMALLY
INVASIVE SURGERY (PCNL / URETEROSCOPY)
(LESS THAN 1 % SHOULD NEED OPEN SURGERY)
35. EXTRA - CORPOREAL SHOCK WAVE LITHOTRIPSY
(ESWL)
SHOCK WAVES GENERATED UNDER WATER CAN
TRAVEL THROUGH BODY WITHOUT ANY APPRECIABLE
LOSS OF ENERGY. WHEN THEY ENCOUNTER STONES
THE CHANGES IN DENSITY CAUSES ENERGY TO BE
ABSORBED AND REFLECTED BY THE STONE & THIS
RESULTS IN FRAGMENTATION OF THE STONES.
40. ESWL-HISTORY
1963-EXPERIMENTS WITH “ SHORT WAVES” IN
W.GERMANY BY PHYSICISTS AT DONIER
SYSTEMS LTD
1980-DORNIER HUMAN MODEL ( HM-3)
LITHOTRIPTER ARRIVED ON MARKET
(STILL GOLD STANDARD WHEN COMPARING
RESULTS WITH NEW MEASUREMENTS
41. ESWL & STAGHORNS
• Dornier HM-3 Monotherapy for STAGSHORNS -
30% Stone Free Rate (In Dilated Collecting System )
• PCNL has higher overall Success
• Combination of PCNL & ESWL can give a
stone free rates of 90% For ALL STONES IN THE
KIDNEY
43. ESWL & URETERIC CALCULI
• For fragmentation fluid medium around
stone necessary
• If stones impacted fragmentation may not
occur
• “PUSH & BANG”-success Marginally
HIGHER THAN “in situ ESWL”
• Trial of “in situ ESWL” – first choice
• “In situ ESWL” FAILS- “Rescue procedure”
44. ESWL COMPLICATIONS
• Haematuria – is quite common ( short term
antibiotics Recommended )
• Incomplete stone Fragmentation & Obstruction
• “Stienstrasse” ( stone street ) usually due to a
large “ Leading fragment”
( Stents Recommended prior to ESWL for
Calculi > 1.5 cm )
48. FRAGMENTATION BY SHOCK
WAVES
ON COLLISION OF “ SHOCK WAVES” WITH
CALCULI-
• ON FRONT SURFACE – COMPRESIVE FORCES
• ON BACK SURFACE OF THE STONE-
REFLECTION OF COMPRESSION PULSE
CREATES NEGATIVE OR TENSILE WAVE THAT
TRAVEL BACK WARD THROUGH CALCULI
• ONCE TENSILE FORCE EXCEEDS “ COHESIVE
STRENGTH” OF CALCULI- FRAGMENTATION
OCCURS
49. ESWL – SPARK GAP/ EHL
• Electro-hydraulic Generator Located at Base of
Water Bath
• Produces Shock wave by Electric Spark Gap of
15,000 to 25,000 Volts Lasting 1 Sec
• High Voltage Spark Discharge Rapidly-
evaporates Water & Generators A “Shock Wave”
by expanding Sarrounding Liquid
50. Mechanism of Stone Fragmentation by ESWL
• On Front Surface – Compresive or positive Forces
• On Back Surface Of The Stone-
Reflection Of Compression Pulse Creates Negative
Or Tensile Wave That Travel Back Ward Through
Calculi
• Once Tensile Force Exceeds “ Cohesive Strength”
Of Calculi- Fragmentation Occurs
• Cavitation – Small air bubbles
52. Diet & Fluid Advice
• High Fluid Intake
• Restrict Salt (Na)
• Oxalate Restrict
• Avoid high intake of Purine food
• Increased citrus fruits may help
• If hypercalciuria restrict Ca intake
Role of Potassium Citrate in preventing Cal Oxalate stone ds – KCit lowers
urinary calcium whereas Na Citrate does not lower Calcium due to Sodium load
53. LIQUIDS
Moderate Amounts : High Amounts :
Apple Juice Cocoa
Beer Fresh Tea
Coffee
Cola
FOODS :
Almonds, Asparagus, Cashew Nuts, Currants, Greens,
Plums, Raspberries, Spinach
54. HIPPOCRATIC OATH :
“I Will not cut, even for the stone, but leave such
procedures for the practitioners of the craft”