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A patient present with pain and tenderness in the left iliac fossa. USG shows a 2 cm stone in the renal pelvis without any hydronephrosis. Most appropriate management:
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Ureteric stone πͺ¨ climbs the nerve ladder πͺ β hits Genitofemoral π― β groin/scrotum pain π£.
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Ureteric colic pain is referred along this nerve because the ureter shares visceral afferent fibers with L1βL2 spinal segments.
Hence, stone in the ureter causes loin-to-groin pain radiating along genitofemoral distribution.
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Referred pain from ureteric colic is felt in the groin due to involvement of the following nerve:
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Proteus species are urease-producing bacteria.
Urease splits urea β ammonia β raises urine pH β alkaline urine.
Alkaline urine + cloudiness with pus cells indicates urinary tract infection with Proteus.
This environment also favors struvite (triple phosphate) stone formation.
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A patient with alkaline urine which is cloudy with plenty of pus cells is suffering from infection with:
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Ψ§ΩΨ§ Ψ¨ΨΉΨ― ΩΨΊΩΨ· ΩΩ Ψ³Ψ€Ψ§Ω Ω
ΩΨ¨Ω ΨΉΩΩΩ Ψ£ΩΨ«Ψ± Ω
Ω Ω
Ψ±Ψ© πππ
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Classic triad:
1. Renal colic β sudden flank pain.
2. Flank/loin swelling β due to hydronephrosis.
3. Disappearance of swelling after urination β as urine passes.
