COMMON DIAGNOSIS AND MANAGEMENT IN
ACUTE CARE FINAL ACTUAL TEST PAPER 2026
COMPLETE QUESTIONS AND ANSWERS
GRADED A+
◉ How does Renal calculi form? Answer: formed d/t elevated levels
of minerals in the body
◉ What minerals in excess can cause renal calculi? Answer: calcium
oxalate (most common),
phosphate
uric acid
struvite
cystine
◉ Urolithiasis Answer: stone in the bladder
◉ Ureterolithiasis Answer: condition of stones in the ureter
◉ Risk Factor & complications of renal calculi Answer: -Male, 20-
50yo, previous stones, obesity, HTN, diabetes, low fluid intake.
,-complications of stones: obstructions, pyelonephritis (kidney
infection), CKD
◉ Classic Kidney stone presentation Answer: acute onset of severe,
colicky flank pain that wax and wane in intensity.
Severe pain is associated with the movement of the stone and can
cause n/v.
pt may seem anxious and unable to sit still
◉ history and physical for nephrolithiasis (kidney stones) Answer:
Irritative Bladder symptoms -dysuria (painful or difficulty
urinating), urgency, & frequency
Vague flank pain or acute colicky pain with increasing intensity
Radiation of pain into the groin
Costovertebral angle (CVA) tenderness
Hematuria
Diaphoretic, tachycardic, appear extremely uncomfortable
◉ CVA tenderness tell your the stone is located where? Answer:
caused by passing of the stone through the ureter with obstruction &
spasm
,◉ Where is the stone located if the patient has pain in the groin
region? Answer: pain that radiates downward into the groin
indicates the stone has passed into the lower third of the ureter
◉ Vague flank pain or acute colicky pain with increasing intensity
means the stone is located where? Answer: stones in renal pelvis
◉ Differential Diagnosis for abdominal pain and/or flank pain:
Answer: Nephrolithiasis (kidney stones)
Pyelonephritis (kidney infection)
Ectopic pregnancy
Ovarian or testicular torsion
Appendicitis
Bowel obstruction
Diverticulitis
Rupture of aortic aneurysm
◉ Right lower abdominal tenderness with a +Blumberg sign. What
should be suspected? Answer: Blumberg sign: Rebound tenderness
in the RLQ, caused by acute peritonitis.
*Appendicitis
◉ What labs do we run to diagnose a kidney stone? Answer: UA
dipstick, urine microscopy and urine C&S
, Serum blood urea nitrogen (BUN) and creatinine (Cr) to assess renal
function.
◉ What radiology methods are preferred for outpatient treatment
and why Answer: inexpensive, easily accessible. in combo its more
practical
-KUB xray
-Renal Ultrasound
◉ What stones can be seen on a KUB?
What stone can you not see on a KUB Answer: CAN see: Calcium
oxalate - most common type of stone
CANNOT see: uric acid stones (radio translucent)
◉ What is a Renal Ultrasound used for when testing for kidney
stones? Answer: good for assessing for hydronephrosis (excess fluid
in the kidney d/t back up of urine that can be caused by an
obstruction). Bad for identifying a stone.
◉ What is the GOLD STANDARD for diagnosing a kidney stone?
Answer: Non-contrast CT scan.
◉ Goal of renal calculi treatment Answer: focused on symptomatic
relief
ACUTE CARE FINAL ACTUAL TEST PAPER 2026
COMPLETE QUESTIONS AND ANSWERS
GRADED A+
◉ How does Renal calculi form? Answer: formed d/t elevated levels
of minerals in the body
◉ What minerals in excess can cause renal calculi? Answer: calcium
oxalate (most common),
phosphate
uric acid
struvite
cystine
◉ Urolithiasis Answer: stone in the bladder
◉ Ureterolithiasis Answer: condition of stones in the ureter
◉ Risk Factor & complications of renal calculi Answer: -Male, 20-
50yo, previous stones, obesity, HTN, diabetes, low fluid intake.
,-complications of stones: obstructions, pyelonephritis (kidney
infection), CKD
◉ Classic Kidney stone presentation Answer: acute onset of severe,
colicky flank pain that wax and wane in intensity.
Severe pain is associated with the movement of the stone and can
cause n/v.
pt may seem anxious and unable to sit still
◉ history and physical for nephrolithiasis (kidney stones) Answer:
Irritative Bladder symptoms -dysuria (painful or difficulty
urinating), urgency, & frequency
Vague flank pain or acute colicky pain with increasing intensity
Radiation of pain into the groin
Costovertebral angle (CVA) tenderness
Hematuria
Diaphoretic, tachycardic, appear extremely uncomfortable
◉ CVA tenderness tell your the stone is located where? Answer:
caused by passing of the stone through the ureter with obstruction &
spasm
,◉ Where is the stone located if the patient has pain in the groin
region? Answer: pain that radiates downward into the groin
indicates the stone has passed into the lower third of the ureter
◉ Vague flank pain or acute colicky pain with increasing intensity
means the stone is located where? Answer: stones in renal pelvis
◉ Differential Diagnosis for abdominal pain and/or flank pain:
Answer: Nephrolithiasis (kidney stones)
Pyelonephritis (kidney infection)
Ectopic pregnancy
Ovarian or testicular torsion
Appendicitis
Bowel obstruction
Diverticulitis
Rupture of aortic aneurysm
◉ Right lower abdominal tenderness with a +Blumberg sign. What
should be suspected? Answer: Blumberg sign: Rebound tenderness
in the RLQ, caused by acute peritonitis.
*Appendicitis
◉ What labs do we run to diagnose a kidney stone? Answer: UA
dipstick, urine microscopy and urine C&S
, Serum blood urea nitrogen (BUN) and creatinine (Cr) to assess renal
function.
◉ What radiology methods are preferred for outpatient treatment
and why Answer: inexpensive, easily accessible. in combo its more
practical
-KUB xray
-Renal Ultrasound
◉ What stones can be seen on a KUB?
What stone can you not see on a KUB Answer: CAN see: Calcium
oxalate - most common type of stone
CANNOT see: uric acid stones (radio translucent)
◉ What is a Renal Ultrasound used for when testing for kidney
stones? Answer: good for assessing for hydronephrosis (excess fluid
in the kidney d/t back up of urine that can be caused by an
obstruction). Bad for identifying a stone.
◉ What is the GOLD STANDARD for diagnosing a kidney stone?
Answer: Non-contrast CT scan.
◉ Goal of renal calculi treatment Answer: focused on symptomatic
relief
