Lecture On Kidney Stone Formation (Nephrolithiasis): Types, Causes, Diagnosis & Prevention | MBBS скачать в хорошем качестве

Lecture On Kidney Stone Formation (Nephrolithiasis): Types, Causes, Diagnosis & Prevention | MBBS

Delve into the comprehensive world of kidney stone formation (Nephrolithiasis) with this detailed medical lecture from Santiniketan Medical College & Hospital. Tailored for medical students, healthcare professionals, and individuals interested in urology and kidney health, this video covers everything from stone types and pathophysiology to diagnosis and crucial prevention strategies. 🩺 Key Topics Covered in This Nephrolithiasis Lecture: Understanding Nephrolithiasis [00:00]: Learn the definition of kidney stone formation – the development of hard substances within the kidney from urine constituents. Types of Kidney Stones [00:58]: Discover the different classifications of kidney stones based on their composition: Calcium Oxalate [01:13]: The most common type, accounting for 70-80% of cases. Calcium Phosphate [01:26]: Makes up 15-20% of cases. Uric Acid Stone [01:33] Struvite Stone (Triple Phosphate Stone) [01:40]: Primarily associated with urinary tract infections (UTIs) caused by urea-splitting organisms like Klebsiella, Proteus, and Providencia [02:45]. Cystine Stone [01:50] Pathophysiology of Kidney Stone Formation [04:40]: Supersaturation & Precipitation [05:56]: How urine becomes supersaturated with solutes, leading to precipitation. Randall's Plaque Formation [10:07]: The initial precipitation of calcium phosphate salts in the renal interstitium, causing erosion of renal papillae and forming a plug on which other stone components deposit. Struvite Stone Mechanism [13:02]: How urea-splitting bacteria raise urine pH, causing rapid precipitation of calcium phosphates and forming staghorn calculi that can obstruct the entire kidney. Risk Factors for Stone Formation [14:58]: Dietary Factors [15:21]: Foods high in oxalate (e.g., potato, spinach, almond) and purine (red meat), as well as excess sucrose and alcohol intake. Endogenous Oxalate [17:29]: Primary hyperoxaluria due to errors in oxalate metabolism, and the role of Vitamin B6 deficiency [20:09]. Calcium Excretion [23:41]: Impact of excess dietary calcium and the difference between dietary and supplemental calcium absorption. Urine pH [28:11]: How acidic urine promotes uric acid and cystine stones, while alkaline urine favors calcium phosphate stones. Citrate Levels [30:13]: Citrate acts as a natural inhibitor of stone precipitation; its reabsorption in acidosis can increase stone risk. Vitamin C Intake [33:08]: Excess Vitamin C can metabolize into oxalate, increasing stone risk. Medication-Induced Stones [35:18]: Drugs like Triamterene and certain sulfonamides can precipitate stone formation. Clinical Features [36:30]: Asymptomatic Presentation [36:49]: Many cases are asymptomatic and discovered incidentally. Pain Abdomen (Renal Colic) [37:20]: Highly characteristic pain that can mimic other conditions like cholecystitis or acute appendicitis, with radiation to the testes or labia. Urinary Symptoms [41:06]: Increased frequency, urgency, dysuria, and acute retention of urine due to ureteral irritation or obstruction. Other Symptoms [44:03]: Nausea, vomiting, hematuria (microscopic or macroscopic) due to inflammation or infection. Investigations & Diagnosis [45:29]: Routine blood and urine tests, USG whole abdomen (most preferred initial imaging), X-ray abdomen, and CT abdomen (with or without contrast). Treatment & Prevention [47:40]: Pain Management [48:02]: Use of antispasmodics and NSAIDs. Stone Expulsion Facilitation [49:08]: For stones less than 6mm, drugs like Deflazacort (steroid) and Tamsulosin can aid expulsion. Management of Infection [50:32]: Antibiotics for associated UTIs; pyelonephritis requires surgical emergency (e.g., pressure release). Stone Removal Procedures [51:41]: Extracorporeal Shock Wave Lithotripsy (ESWL) for breaking stones outside the body, and Percutaneous Nephrolithotomy (PCNL) for invasive removal. Prevention Strategies [58:22]: Key advice includes increased water intake, reduced animal protein, moderate dietary calcium, avoiding calcium supplements, managing urine pH, increasing citrate intake (e.g., from lemons), and reducing excess Vitamin C. This lecture offers essential knowledge for effective management and prevention of kidney stones, a common and often painful condition. SANTINIKETAN MEDICAL COLLEGE & HOSPITAL Real Classroom Demonstration/Lecture On: O MEDICINE by Dr. Sk. Sarafat Hossain (MBBS Batch: 2023-24) Conducted on: 25-10-25