GMCH Chandigarh - 2019
Medical & Surgical Nursing
Easy
Which of the following conditions is related to the development of renal calculi?
Appeared in: GMCH Chandigarh - 2019
Explanation
- Gout is a metabolic disease characterized by hyperuricemia, an excess of uric acid in the blood.
- This excess uric acid can precipitate in the urinary tract, especially in acidic urine, to form uric acid stones.
- The link between gout and uric acid nephrolithiasis is direct and well-established, making it a primary risk factor.
Why Other Options Were Wrong
- Option A: Pancreatitis is not a direct cause of renal calculi. While severe acute pancreatitis can lead to dehydration, which is a general risk factor for all stone types, there is no specific metabolic link.
- Option B: A fractured femur itself does not cause kidney stones. The risk is indirect and related to the consequence of the injury.
- Option D: There is no established pathophysiological link between spinal disc disease and the formation of renal calculi.
Related Visual
Clinical Relevance
- Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Pathophysiological conditions leading to renal calculi formation as background academic context rather than a clinical decision trigger.
- Nurses should recognize that a patient with a history of gout is at high risk for uric acid stones and may require specific dietary education (low-purine diet) and urine pH monitoring.
- A key nursing responsibility for any patient with suspected nephrolithiasis is to strain all urine to collect stones for analysis, as the stone type dictates the prevention strategy.
- What if? If the patient had a history of recurrent UTIs with Proteus bacteria instead of gout, the most likely type of stone would be struvite (infection) stones, and the focus of care would be on eradicating the infection.
How to Approach the Question
- First, identify the core of the question: it asks for a condition that is 'related to' the development of renal calculi (kidney stones). This requires knowledge of risk factors and underlying diseases.
- Evaluate each option based on its known pathophysiological connection to stone formation.
- Consider Gout: Recall that gout is a disorder of purine metabolism leading to high uric acid levels. This directly links to uric acid stones.
- Consider Fractured femur: Think about the consequences. A major fracture often leads to prolonged bed rest (immobilization). Immobilization causes calcium to be released from bones, increasing urine calcium (hypercalciuria), a risk for calcium stones. This is an indirect link.
- Consider Pancreatitis and Disc disease: Evaluate if there is any known metabolic or physiological link. For these two, there is no direct association.
- Compare the strength of the associations. Gout is a direct metabolic cause of a specific stone type. The link with a fractured femur is indirect (via immobilization). Therefore, Gout is the strongest and most direct answer.
Concept Tested & Keywords
- Concept Tested: Pathophysiological conditions leading to renal calculi formation.
- Stem keywords: conditions, development, renal calculi
- Lead-in keywords: related to
Question ID
QTofMXY5ZJJv0NXVGrwstc
Reference Book
E6 Pathology- ROBBINS & COTRAN PATHOLOGIC BASIS OF DISEASE 10TH Ed p. 947-949
E6 Medicine Harrison 22e Part 2 p. 352-354
Practise the full GMCH Chandigarh - 2019
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