AMC EXAMS AUSTRALIA ,AUSTRALIAN MEDICAL EXAMS,MCQS,CLINICALS.

http://amcexams.blogspot.com/?spref=gb ■ Abdominal examination is most rewarding after ensuring adequate analgesia. ■ Plain KUB has a sensitivity of only 45-59% and a specificity as low as 77% – it cannot be used to rule in or rule out the diagnosis of ureteric calculi. ■ Infection with obstruction mandates urgent decompression. ■ There is evidence of permanent nephron loss within 72 hours of complete obstruction. ■ The likelihood of spontaneous stone passage is determined by stone size and position. ■ Fifteen to twenty per cent of all patients with ureteric calculi will require intervention using ESWL, ureteroscopy or percutaneous nephrolithotomy.

1.Obstruction with evidence of infection-urgent decompression. 2.larger calculi -more than 6mm 3.Bilateral obstruction. 4.An obstructed solitary or transplanted kidney. 5.Renal impairment.(review the definition of renal impairment) 6.Ongoing unacceptable discomfort.

Haematuri a (usually microscopic but sometimes frank) occurs in 95% of patients with renal colic on day one and 65% by day three, but up to 87% of patients with AAA rupture will also have haematuria.