Kidney stones
Medgeeks with Andrew Reid
Medgeeks
4.8 • 997 Ratings
🗓️ 4 September 2019
⏱️ 15 minutes
🧾️ Download transcript
Summary
It's 7:30 am and a 55 year old male presents to your emergency department complaining of stabbing pain in his right side, which woke him up from sleep, about 20 minutes ago.
As you walk into the room, you see him pacing around, clutching his side and slightly hunched over.
He won't sit still and can barely complete a sentence before groaning from all the pain.
He has a past medical history of hypertension and diverticulitis. He denies any associated symptoms and states yesterday he felt normal.
The triage nurse obtained a urine sample showing hematuria. What do you do...?
Today, we'll be discussing kidney stones and we will be answering a couple of your questions regarding acute kidney injury and post exposure prophylaxis after a needle stick.
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Transcript
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| 0:00.0 | It's 730 a.m. A 55 year old man presents to your emergency department complaining of stabbing pain in his right side that woke him up from sleep about 20 minutes ago. |
| 0:11.0 | As you walk into the room you see he's pacing around the room, |
| 0:14.6 | clutching his right side, slightly hunched over. He's very uncomfortable. As you try to |
| 0:19.2 | talk to him, he won't sit still, just keep sitting down, standing back up, laying on one side, rolling to the other. |
| 0:25.4 | He can barely complete a sentence before groaning due to all the pain. |
| 0:28.4 | He's got a past medical history of hypertension and diverticulitis. |
| 0:31.8 | No prior surgeries. |
| 0:33.4 | He didn't even have time to take pain medicine before coming to the ED |
| 0:36.5 | because it was so severe. |
| 0:37.7 | There's no associated symptoms. |
| 0:39.4 | Yesterday he felt totally normal. |
| 0:41.4 | The triage nurse already obtained a urine sample which you now glance at sitting on the |
| 0:45.8 | Mayo stand. It's blood with another episode of the Med Geek's |
| 1:05.3 | podcast. Thanks for tuning in. Today we're talking about Kidney Stones. Later on in |
| 1:10.3 | the episode I'm going to answer a question about acute kidney injury and |
| 1:14.3 | post-exposure prophylaxis after a needle stick injury. Let's talk about kidney |
| 1:18.4 | stones. Kidney stones are common. Approximately 20% of men and 10% of women will have a kidney stone at least one in their lifetime. |
| 1:28.0 | The vast majority of these, 75% of them, are calcium stones. |
| 1:32.0 | About 15% are struvite, which is magnesium, ammonium, and |
| 1:36.5 | phosphate, and then the last 10% are composed of uric acid. 25% of goutpat patients will get a kidney stone. |
| 1:44.0 | So in terms of the pathophysiology, most are caused by hypercalcioria. |
| 1:49.0 | Most of these patients also have insufficient water intake. |
... |
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