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A 44-year-old man presents to the emergency department complaining of acute right colicky flank pain with radiation to the right testicle. A plain abdominal film shows no acute disease but a noncontrast computed tomography (CT) scan shows a 2-mm radiolucent stone in the right ureteropelvic region. Serum calcium was 8.9 mg/dL. Aside from pain management and increasing his fluid intake to more than 2 L/d, what is the most appropriate next step in management?

1.prescribe urease inhibitors (acetohydroxamic acid)
2.refer to urology for shock wave lithotripsy
prescribe colchicine
3.prescribe oral sodium citrate and citric acid solution
4.refer to urology for ureteroscopy

most likely he has uric acid stone
We should alkalinize his urine w/oral sodium citrate and citric acid solution or with sodium bicarbonate.

Correct if wrong.

YA,IT IS URIC ACID ONE AND LESS THAN 5MM SO ALKALINE AND GIVE FLUIDS

5MM TO 2CM STONES ,NEEDS LITHOTRIPSY,????

prescribe colchicine

33

_ 333. alkalinized urine

3.which other stones are radiolucent

3.prescribe oral sodium citrate and citric acid solution

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