Rolling Stones: Renal Edition
Not Your Average Cramps
Hands On, Gloves On
DDx Files: The Truth Is Somewhere in the Symptoms
What Happens in Vegas… Comes to the Clinic
100
This is the classic symptom described by patients with kidney stones, often severe and colicky in nature.
What is flank pain?
100
This condition presents with vaginal bleeding and a positive pregnancy test, often before 12 weeks, and can be classified as threatened, inevitable, incomplete, or complete.
What is spontaneous abortion (miscarriage)?
100
This lesion is a classic finding in primary syphilis. 
What is a chancre?
a single painless, round ulcer with clean base and raised edges on the genitalia
100
This common cause of right lower quadrant pain can mimic ureteral stone pain, especially in younger patients.
What is appendicitis?
100
A woman with frothy, greenish vaginal discharge and a “strawberry cervix” on speculum exam likely has this protozoal infection.
What is trichomoniasis?
200
This physical exam finding is often present on the affected side, but its absence doesn’t rule out stones.
What is costovertebral angle tenderness (CVA tenderness)?
200
This life-threatening condition presents with unilateral pelvic pain, vaginal bleeding, and a positive pregnancy test, usually around 6–8 weeks gestation.
What is ectopic pregnancy?
200
This painful exam finding suggests inflammation of the uterus or adnexa, often positive in pelvic inflammatory disease.
What is cervical motion tenderness?
200
This gynecologic emergency can present with sudden lower abdominal pain, nausea, and adnexal tenderness, mimicking renal colic in women.
What is ovarian torsion?
200
This bacterial STI is characterized by painful, purulent urethral discharge and can co-infect with chlamydia.
What is gonorrhea?
300
This common urinalysis finding is seen in over 85% of patients with kidney stones.
What is hematuria?
300
This condition, typically seen in the third trimester, presents with painless vaginal bleeding and requires avoidance of vaginal exam until imaging confirms placental position.
What is placenta previa?
300
This painful ulcer with an irregular border is commonly caused by Haemophilus ducreyi.
What is chancroid?
First-line Treatment Options:
Azithromycin 1 gram orally in a single dose
ORCeftriaxone 250 mg intramuscularly in a single dose
ORCiprofloxacin 500 mg orally twice daily for 3 days
ORErythromycin base 500 mg orally four times daily for 7 days
300
This condition involves infection and inflammation of the upper urinary tract and can also present with flank pain and fever.
What is pyelonephritis?
300
This chronic condition can result from untreated chlamydia or gonorrhea, causing pelvic pain and infertility in women.
What is pelvic inflammatory disease (PID)?
400
This imaging modality is the gold standard for diagnosing kidney stones, especially when rapid diagnosis is needed.
What is a non-contrast CT of the abdomen and pelvis?
400
This OB/GYN emergency is associated with sudden, severe pelvic pain, often with a history of ovarian cysts, and shows decreased or absent blood flow on Doppler ultrasound.
What is ovarian torsion?
400
A painful, swollen mass at the 4 or 8 o’clock position of the vaginal introitus that causes discomfort with sitting or walking is most likely this condition.
What is a Bartholin’s abscess?
400
This vascular emergency can cause sudden, severe flank or abdominal pain and must be ruled out in older patients or those with risk factors.
What is abdominal aortic aneurysm (AAA)?
AAA can present with flank pain and hematuria. Document the absence of a pulsatile mass, equal femoral pulses and lack of abd tenderness.
400
This painful genital ulcer with a grey base is caused by a bacterial infection common in tropical regions and can lead to lymphadenopathy.
What is chancroid?
500
This common analgesic class is preferred for pain control due to its effectiveness at relieving ureteral smooth muscle spasm.
What are NSAIDs?
500
A blood pressure ≥140/90 after 20 weeks gestation, proteinuria, and new-onset headaches point to this diagnosis.
What is preeclampsia?
500
These painful genital sores are caused by this viral infection.
What is herpes simplex virus (HSV)?
painful, multiple vesicular lesions grouped on an erythematous base
500
This GI condition can mimic kidney stone pain due to its retrocecal position and is often associated with nausea, anorexia, and leukocytosis.
What is diverticulitis?
500
This antibiotic is the first-line treatment for all stages of syphilis, typically given as an intramuscular injection.
What is benzathine penicillin G?
For patients allergic to penicillin, doxycycline or tetracyclines antibiotics may be used as an alternative in early syphilis.