Lesson 1Relevant renal and urinary tract anatomy: kidney, collecting system, ureteral course, relations causing referred painThis lesson reviews kidney and ureter setup for stone issues, like collecting cups, pelvis, narrow ureter spots, blood vessel and pelvis links, and why pain spreads to side, groin, and private parts.
Renal cortex, medulla, and collecting systemRenal pelvis and calyceal anatomyUreteral course and narrow segmentsRelations to vessels, bowel, and pelvisPathways of referred flank and groin painLesson 2History elements: onset, prior stones, metabolic history, family history, medication/occupation risk factorsThis lesson lists key history for suspected stones, like pain start, past stones, body chemistry and illness, family links, food, drugs, job, and factors hinting at trouble or repeats.
Character and timing of pain episodesPast stones, procedures, and outcomesMetabolic and systemic disease historyFamily history and genetic conditionsDiet, fluid intake, drugs, occupationLesson 3Physical exam maneuvers: costovertebral angle tenderness, abdominal exam, testicular/inguinal exam when indicatedThis lesson details targeted body checks for sudden side pain, like vital signs, belly and kidney angle press, private and groin exams when needed, and signs of other problems.
Vital signs and overall illness severityCostovertebral angle tenderness techniqueAbdominal exam for peritonitis or massGenital and inguinal exam when neededSigns pointing away from stone diseaseLesson 4Stone prevention basics: metabolic workup indications, 24-hour urine testing, dietary and pharmacologic prevention strategiesThis lesson starts stone prevention, with when to check body chemistry, 24-hour urine tests, food advice, drink goals, and drugs matched to stone type and personal risks.
Who needs full metabolic workupCollecting and interpreting 24‑hour urineFluid intake and urine volume targetsDietary sodium, protein, and oxalate advicePharmacologic prevention by stone typeLesson 5Acute management: analgesia ladder (NSAIDs vs opioids), antiemetics, medical expulsive therapy evidence and limitsThis lesson covers urgent care for kidney pain, like NSAID pain relief first, careful opioids, anti-sickness drugs, fluids, stone-pushing drug proof and limits, and watch vs admit rules.
Analgesia ladder and NSAID first strategyOpioid indications and safety concernsAntiemetics and fluid managementMedical expulsive therapy evidenceDisposition, follow‑up, and return precautionsLesson 6Evidence sources: major guidelines and reviews for suspected kidney stones (names and years to search)This lesson sums up key guidelines and reviews on suspected kidney stones, noting main groups, years, and quick ways to find and judge evidence for test and treatment choices.
Major urology and nephrology guidelinesEmergency medicine stone care guidelinesHigh‑impact systematic reviews and yearsSearching PubMed and guideline portalsAppraising guideline strength and gapsLesson 7Initial diagnostics: urinalysis for hematuria/infection, urine microscopy, serum electrolytes, renal function, inflammatory markersThis lesson details starting lab checks for suspected stones, like urine for blood/germs, microscope, blood salts, kidney work, and swelling markers, with meaning for diagnosis and risk.
Urinalysis for hematuria and infectionUrine microscopy for crystals and castsSerum creatinine and estimated GFRElectrolytes, calcium, and uric acidInflammatory markers and sepsis cluesLesson 8Indications for emergent urology referral: obstruction with infection, refractory pain, impaired renal function, anuriaThis lesson sets urgent urology needs, like blocked infected systems, pain or vomiting not stopping, one kidney or kidney failure, no urine, and special cases in pregnancy and kids.
Obstruction with sepsis or high feverRefractory pain or intractable vomitingAcute kidney injury and solitary kidneyAnuria, bilateral obstruction, pregnancyPediatric and complex comorbidity casesLesson 9Imaging strategy: when to use non-contrast CT KUB, ultrasound in pregnancy, plain radiography limitations, contrast indicationsThis lesson describes scan picks for stones, main non-contrast CT, ultrasound for pregnancy and youth, plain x-ray limits, and when contrast needed for issues.
Non‑contrast CT KUB indicationsUltrasound in pregnancy and youthStrengths and limits of plain radiographyWhen to use contrast CT or urographyRadiation exposure and dose reductionLesson 10Stone pathophysiology and types: calcium, uric acid, struvite, cystine — formation mechanisms and metabolic risk factorsThis lesson reviews stone types and making, like calcium, uric acid, struvite, cystine, crystal start, urine overload, germ links, and body chemistry and setup risks.
Calcium oxalate and calcium phosphate stonesUric acid stone formation mechanismsStruvite stones and urease‑producing bacteriaCystine stones and inherited disordersMetabolic, urinary, and anatomic risk factorsLesson 11Typical clinical presentation: colic characteristics, hematuria, nausea/vomiting, pain radiation to groin/scrotum/labiaThis lesson explains usual and odd signs of kidney pain waves, like pain feel, timing, spread, urine and stomach signs, and danger signs for other serious issues.
Pain onset, severity, and colicky patternRadiation to flank, groin, and genitaliaHematuria and lower urinary symptomsNausea, vomiting, and autonomic signsRed flags for alternative diagnoses
