Flank Pain and Kidney Stones

EM Clerkship

Zack Olson, MD and Michael Estephan, MD

Education, Courses, Health & Fitness, Medicine

5 • 795 Ratings

🗓️ 19 August 2018

⏱️ 10 minutes

🔗️ Recording | iTunes | RSS

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Summary

Kidney Stones are a Diagnosis of Exclusion!!! Step 1: Consider the Differential Diagnosis for Flank Pain Appendicitis Abdominal Aortic Aneurysm Ectopic Pregnancy Testicular/Ovarian Torsion Kidney Stone Step 2: Diagnose the Kidney Stone Option 1- Renal Ultrasound Findings consistent with kidney stone diagnosis Hydronephrosis Lack of ureteral jets (in bladder) Kidney stones (poor sensitivity for this) […]

Transcript

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0:00.0	Hello, med students.
0:02.7	My name is Zach Olson, and thank you for downloading this week's episode of the EM Clerkship Podcast.
0:12.6	Let's get back to some clinical content this week.
0:16.0	Here's your case.
0:23.6	No four? Okay.
0:24.6	Yeah, we're in four.
0:26.6	All right, buddy, you got a 23-year-old female left lower flank pain, sharp, non-radiating,
0:33.6	complaining at 8 out of 10 on the pain scale.
0:35.6	Started approximately two days ago, but no related trauma that she can remember anyway.
0:42.3	No meds, no allergies, no medical history, state she is a runner.
0:46.3	We did administer 6 milligrams ketamine IV for pain.
0:51.3	EKG with sinus attack at 120, BP 130 over 80, 98% on room air, and glucose is
0:58.7	130 she ate about 20 minutes ago she says anybody have any questions okay
1:06.0	thank you.
1:14.7	All right.
1:16.9	So, bad flank pain.
1:20.2	The vast majority of the time, when you hear a sign-out like this, when you see flank pain on the chart,
1:23.3	your first thought is probably going to be,
1:25.7	especially after you've been doing this for a while,
1:28.9	this sounds like a kidney stone.
1:30.7	Let's get them some pain medicine, et cetera, et cetera.
1:33.4	And the approach to severe, crampy flank pain, which 99% of the time is a kidney stone,
	...

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