Editing Stones: Epidemiology and Pathogenesis (section)

== Answers ==

# List inhibitors of calcium oxalate formation.
## Nephrocalcin
## Magnesium
## Bikunin
## Citrate
## Tamms-Horsfall protein
## Uropontin
# What are functions of PTH?
## Stimulates reabsorption of calcium and excretion of phosphate in kidney
## Stimulates release of calcium from bone
## Stimulates to 1-alpha-hydroxylase enzyme to produce activated vitamin D
# What stimulates release of PTH?
#* Hypocalcemia
# What are the functions of vitamin D?
## Increase intestinal calcium absorption (Note PTH does not target intestine)
## Increases renal reabsorption of calcium and phosphate (Note PTH increases phosphate excretion)
## Increases calcium release from bone
## Inhibits release of PTH
# What is the most common metabolic abnormality found in stone formers?
#* Hypercalcuria
# What are 4 different types of hypercalcuria and what would their blood work show?
## Absorptive, normal serum calcium, normal/supressed PTH
## Renal leak, normal serum calcium, elevated PTH
## Resorptive, elevated serum calcium, elevated PTH
## Idiopathic
# What are the 4 different types of hyperoxaluria?
## Primary
## Enteric
## Dietary
## Idiopathic
# Why is intestinal malabsorption associated with hyperoxaluria?
#* Intestinal malabsorption of fat results in saponification of fatty acids with calcium and other substrates that would otherwise bind oxalate; this results in increased oxalate absorption
# List 5 oxalate rich foods
#* Okra, rhubarb, chocolate, pepper, nuts, beets, spinach
# What is the most common cause of hyperuricosuria?
#* Increased dietary intake of purine
# List 6 causes of hyperuricosuria
## Gout
## Myeloproliferative disorder
## Multiple myeloma
## Thalassemia
## Hemolytic disorders
## Pernicious anemia
## Hemoglobinopathies
## Secondary polycythemia
## Complete or partial hypoxanthine-guanine phosphoribosyltransferase (HGPRT) deficiency
## Overactivity of phosphoribosylpyrophosphate synthetase
## Hereditary renal hypouricemia
# List 8 causes of acquired RTA
## Analgesic abuse
## Hypercalcemia
## ATN
## Sarcoidosis
## Hyperparathyroidism, primary
## Pyelonephritis, recurrent
## Obstructive uropathy
## Transplant, renal
# What are the 3 different types of RTA, metabolic abnormality, and which is associated most commonly with stones?
## Type 1: impaired H+ secretion, associated with stones
## Type 2: impaired bicarb reabsorption
## Type 4: renal failure
# List 4 causes of hypocitraturia
## Idiopathic
## Type 1 RTA
## Thiazide diuretics
## Chronic diarrhea
# What are 2 lithogenic metabolic derangements associated with thiazide use?
#* Hypomagnesuria and hypocitraturia
# List 10 conditions associated with uric acid stones
## Chronic diarrhea
## Diabetes
## Obesity
## Metabolic syndrome
## Tumour lysis syndrome
## Volume depletion
## High animal protein intake
## Uricosuric drugs
## All 11 conditions associated with hyperuricosuria listed above
## Idiopathic
# What are the main determinants of uric acid stone formation?
## Low urine pH (<5.5)
## Low urine volume
## Hyperuricosuria
# What is the inheritance pattern associated with cysteine stones?
#* Autosomal dominant
# Impaired reabsorption of which amino acids occurs in cystinuria?
#* Cystine, Ornithine, Lysine, Arginine
# List 4 radiolucent stones
## Uric acid
## Matrix
## Cystine
## Indinavir
## Trimaterene
## Xanthine
## 2,8-dihydroxyadenine stone
# Which metabolic abnormality is associated with excess vitamin C intake?
#* Hyperoxaluria
# Which type of stone is associated with laxative abuse?
#* Ammonium acid urate stones
# List 5 stone types that are formed from medications?
#* '''Lotta Good Drugs Cause Calculi FIT TEST'''
## '''L'''axatives
## Vitamin '''D'''
## Vitamin '''C'''
## '''C'''arbonic anhydrase inhibitors
## '''F'''urosemide
## '''I'''ndinavir
## '''T'''riamterene
## '''T'''MP/SMX
## '''E'''phedrine
## '''S'''ilicates
## '''T'''opiramate
# List anatomic causes the predispose patients to stone formation
## UPJO
## Horseshoe kidney
## Caliceal diverticula
## Medullary sponge kidney