Lesson 1Relevant renal and urinary tract anatomy: kidney, collecting system, ureteral course, relations causing referred painThis reviews kidney and pipe build key to stones, like cups, centre, narrow pipe spots, blood vessel and pelvis ties, and why pain shoots to side, groin, 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 lists key story bits for likely stones, like pain start, past stones, body chem issues, family, food, drugs, work raising repeat or trouble odds.
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 details targeted body checks for sudden side pain, life signs, belly and rib-back feel, private and groin looks when needed, signs of other causes.
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 starts stone stop ways, when for chem checks, day urine test, food tips, drink goals, drugs fit to stone kind 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 covers first help for kidney pain cramps, painkillers like NSAID over strong ones, sick-stop drugs, fluids, push-out med proof and bounds, watch vs stay 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 sums main guideline and review spots for likely kidney stones, key groups, years, easy search and check to guide test and treatment calls.
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 details start lab checks for likely stones, urine for blood/bugs, scope look, blood salts, kidney work, swell signs, reading 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 sets urgent urology calls, like blocked infected pipes, pain/vomit no stop, one kidney fail, no urine, special baby and kid cases.
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 picks scans for stones, main no-dye CT belly, sound in baby time young ones, x-ray limits, dye needs for troubles.
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 reviews stone make-ups and starts, calcium, acid, infection, rare types, crystal grow, over-sweet urine, bug links, body chem and build 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 explains usual and odd kidney cramp signs, pain feel, time, shoot paths, urine gut ties, danger flags for other bad causes.
Pain onset, severity, and colicky patternRadiation to flank, groin, and genitaliaHematuria and lower urinary symptomsNausea, vomiting, and autonomic signsRed flags for alternative diagnoses
