DIAGNOSIS
NUTIRITION THERAPY
PHARMACOLOGIC PREVENTION
CLINICAL PEARLS
Things Residents Should Somehow Know
100

This imaging modality is recommended as the preferred test for suspected nephrolithiasis..

low-dose non-contrast CT scan

100

fluid intake is recommended in patients with kidney stones to achieve a minimum daily urine output of

2.5 L/day

100

Potassium citrate is recommended for people with  

recurrent kidney stones with hypocitraturia and/or low urine pH that persists despite nutrition therapy.

100

These medications are recommended as first-line treatment for acute renal colic

NSAIDs

100

In Breaking Bad, Walter White originally worked as this type of scientist.

chemistry teacher

200

ultrasound has lower diagnostic accuracy, but may be appropriate for imaging in..

-uncomplicated cases

-individuals with recurrent kidney stones

200

Recommend a daily sodium intake is .. in people with calcium-based stones (in mmol and mg)

 < 100 mmol (2300 mg)

200

It is suggested to use thiazide diuretics in people with

recurrent kidney stones and persistent hypercalciuria following nutrition therapy focused on fluid intake, so diumrestriction, and normal calcium intake.

200

• Profound hypocitraturia is ... and this usually requires citrate supplementation

 urine citrate < 0.5 mmol/ 24 h

200

This HBO series became a hit among medical trainees in 2025 (hint: usually watched on night ICU rotation)

The Pitt

300

A recommendation that should be done for all people with recurrent kidney stones..

stone analysis

300

higher urine output is recommended in patients with cystine stones because..

of the low solubility of cystine compared with other types of kidney stones,

300

This major 2023 trial challenged the efficacy of thiazides for stone recurrence prevention.

NOSTONE study

300

Full metabolic evaluation identifies the underlying cause of kidney stones in..

around 90% of cases

300

In the TV show The Office, this regional manager famously grills his foot on a George Foreman grill

Michael Scott

400

It is recommend to do metabolic evaluation for all individuals with kidney stones, what does a basic metabolic evaluation include?

-Patient's history

-Blood testing: Ca, phos, Bicarb etc

-Initial midstream urine testing: check pH and r/o infection

400

It is recommend to achieve  dietary intake for calcium... for people with calcium stones

1000 mg/d

400

The guideline suggests against routine use of this class of medications for stone prevention unless indicated for gout.

xanthine oxidase inhibitors

400

 Low .. diet will increase .. stones 

calcium/oxalate diet

calcium stones

400

The medication residents prescribe themselves before rounds

coffee (or chai)

500

A cystine screen should be considered when stone type is unknown and these two clues are present..

young age at stone formation and/or a strong family history

500

Increased fruit and vegetable consumption help reducing kidney stone formation by (3)

-neutralize dietary acid load

- increase urine pH

-raise urine citrate levels

500

Potassium citrate is preferred over sodium bicarbonate because sodium bicarbonate increases urinary excretion of this electrolyte.

Sodium (may promote sodium urate precipitation)

500

What is the most cost-effective intervention for preventing recurrent stones

Nutrition therapy  

500

In this series, Pedro Pascal protects a child who looks suspiciously like Yoda.

The Mandalorian

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