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Urology
Urolithiasis: Review Questions
Jaime Freyle, MD
Dr. Freyle is a resident at Maimonides Medical Center, Brooklyn,
NY.
Stanley Zaslau, MD
Dr. Zaslau is Assistant Attending Urologist, Division of Urology,
Maimonides Medical Center.
Choose the single best answer for each question.
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1. In industrialized countries, what is the most common type of urinary stone?
- Calcium phosphate
- Calcium oxalate
- Ammoniomagnesium phosphate (struvite)
- Uric acid
- Cystine
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2. All of the following are common signs and symptoms of renal colic EXCEPT:
- Nausea and vomiting
- Pain relief while the patient is lying still on the unaffected side
- Pain in the testicle or labia
- Costovertebral angle tenderness with radiation
- Urinary frequency and urgency
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3. A 48-year-old woman is admitted to the hospital for intravenous hydration and analgesics after experiencing her third bout of renal colic in the past year. Previous intravenous pyelograms revealed recurrent right- and left-sided 3-mm caliceal stones. A current sonogram shows a 3-mm right caliceal stone and a 2-mm distal ureteral stone. Physical examination of the heart and lungs is unremarkable. Abdominal examination reveals right flank tenderness. Which of the following is the LEAST likely diagnosis?
- Hyperparathyroidism
- Gout
- Rheumatoid arthritis
- Sarcoidosis
- Renal tubular acidosis
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4. Which of the following is the most common site of urinary stone impaction?
- Renal calix
- Ureteropelvic junction
- Near the pelvic brim, where the ureter arches over the iliac vessels
- Posterior pelvis, where the ureter is crossed anteriorly by pelvic blood vessels and the broad ligament
- Ureterovesical junction
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5. Hospitalization for renal stones is recommended in all cases EXCEPT:
- A patient whose symptoms are not controlled by oral analgesics
- A patient with an obstructing stone and infected urine on urinalysis
- A patient with an obstructing stone and fever
- A patient with calculous anuria (usually seen in patients with one kidney)
- A patient with multiple recurrences of renal stone formation
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6. Patients who have had ileostomies are at increased risk for urinary stones composed of which one of the following substances?
- Calcium monophosphate
- Calcium phosphate
- Cystine
- Uric acid
- Xanthine
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7. Prostatic stones are usually formed of which of the following substances?
- Calcium oxalate
- Calcium phosphate
- Cystine
- Ammoniomagnesium phosphate (struvite)
- Uric acid
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