Lesson 1Relevant renal and urinary tract anatomy: kidney, collecting system, ureteral course, relations causing referred painDis section reviews renal an ureteral anatomy relevant to stone disease, including calyces, pelvis, ureteral narrowing points, vascular an pelvic relations, an mechanisms of referred pain to flank, groin, an genital regions.
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 factorsDis section outlines key history elements in suspected nephrolithiasis, including pain chronology, prior stones, metabolic an systemic disease, family history, diet, medications, occupation, an factors predicting complications or recurrence.
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 indicatedDis section details focused physical examination in acute flank pain, including vital signs, abdominal an costovertebral angle assessment, genital an inguinal exams when indicated, an findings suggesting alternative diagnoses.
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 strategiesDis section introduces stone prevention, including indications fi metabolic evaluation, 24-hour urine testing, dietary counseling, fluid goals, an pharmacologic therapies tailored to stone type an individual risk profile.
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 limitsDis section covers acute management of renal colic, including NSAID-based analgesia, cautious opioid use, antiemetics, hydration, medical expulsive therapy evidence an limits, an criteria fi observation versus admission.
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)Dis section summarizes key guideline an review sources fi suspected kidney stones, highlighting major societies, publication years, an how fi efficiently search an appraise evidence fi guide diagnostic an therapeutic decisions.
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 markersDis section details initial laboratory evaluation in suspected nephrolithiasis, including urinalysis, urine microscopy, serum chemistries, renal function, an inflammatory markers, wid interpretation fi diagnosis an risk stratification.
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, anuriaDis section defines situations requiring emergent urology involvement, including obstructed infected systems, uncontrolled pain or vomiting, solitary kidney or renal failure, anuria, an special considerations in pregnancy an pediatrics.
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 indicationsDis section describes imaging choices fi suspected stones, focusing pon non-contrast CT, ultrasound in pregnancy an young patients, limited roles of plain radiography, an when contrast studies are needed fi complications.
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 factorsDis section reviews stone composition an formation, covering calcium, uric acid, struvite, an cystine stones, crystal nucleation, urinary supersaturation, infection-related mechanisms, an metabolic an anatomic risk factors.
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/labiaDis section explains di classic an atypical clinical features of renal colic, including pain quality, timing, radiation, associated urinary an gastrointestinal symptoms, an red flags dat suggest alternative or life-threatening diagnoses.
Pain onset, severity, and colicky patternRadiation to flank, groin, and genitaliaHematuria and lower urinary symptomsNausea, vomiting, and autonomic signsRed flags for alternative diagnoses
