Lesson 1Relevant renal and urinary tract anatomy: kidney, collecting system, ureteral course, relations causing referred painReviews kidney and ureter setup for stone trouble, like cups, centre, narrow spots, blood vessel and pelvic links, 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 factorsLists key history for likely stones, like pain start, past stones, body chemistry and illness, family links, food, drugs, job, and factors hinting 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 indicatedDetails targeted body checks for sudden side pain, like vitals, belly and kidney angle press, private and groin looks when needed, and 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 strategiesIntroduces stone stopping, like when for body chemistry checks, full-day urine tests, food advice, drink goals, and drug plans fit 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 limitsCovers sudden kidney pain handling, like NSAID pain relief first, careful opioids, anti-sick drugs, fluids, stone-pass help proof and limits, 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)Sums up top guidelines and reviews for likely kidney stones, naming big groups, years, quick search and check ways 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 markersDetails starting lab work for likely stones, like urine for blood/germs, microscope look, blood salts, kidney work, swelling markers, with reads for diagnosis and risk sort.
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, anuriaDefines urgent urology needs, like blocked infected systems, unstoppable pain or vomiting, one kidney or kidney fail, no urine, plus pregnancy 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 indicationsDescribes scan picks for likely stones, key on no-contrast CT, ultrasound for pregnancy and young ones, plain x-ray limits, when contrast for trouble.
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 factorsReviews stone makeup and forming, covering calcium, uric acid, struvite, cystine, crystal starts, urine overload, germ links, 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/labiaExplains usual and odd signs of kidney gripes, like pain feel, timing, spread, urine and gut signs, danger flags for other or deadly causes.
Pain onset, severity, and colicky patternRadiation to flank, groin, and genitaliaHematuria and lower urinary symptomsNausea, vomiting, and autonomic signsRed flags for alternative diagnoses
