10-26-2008, 07:48 PM
1) A 35 y/o female has a history of recurrent renal calculi and now she comes with another episode of severe left lower quadrant pain that radiates to flank. She also noticed her urine turning red. Urinalysis showed RBCs and a KUB flat plate revealed a 3 mm stone. You advise the patient to drink plenty of fluids and explain her that the stone will most likely pass off. A 24 hour urine studies was significant for increased urinary oxalate at 70mg/day. The patient asks you if she needs to restrict her dietary calcium intake because she is having recurrent stones. She also tells you that she has been using cranberry juice for the past 1 month. Most appropriate response to this patient is :
A) " In view of recurrent stones history and increased urinary oxalate, you will most likely benefit from restricting dietary calcium intake "
B) " Increase your dietary oxalate so that this will bind the calcium in your diet and gets excreted in stool
C) " Stop using cranberry juice as it is responsible for your recurrent stones"
D) " Continue to maintain normal calcium in your diet because low calcium can increase urinary oxalate excretion and thereby stone formation"
E) " You have a huge stone and first this need to be treated surgically"
A) " In view of recurrent stones history and increased urinary oxalate, you will most likely benefit from restricting dietary calcium intake "
B) " Increase your dietary oxalate so that this will bind the calcium in your diet and gets excreted in stool
C) " Stop using cranberry juice as it is responsible for your recurrent stones"
D) " Continue to maintain normal calcium in your diet because low calcium can increase urinary oxalate excretion and thereby stone formation"
E) " You have a huge stone and first this need to be treated surgically"