RTA question for dolly123 - anwar63108

[ArchivalUser]

this pt could develop which combination of kidney stone?
(a) uric acid and struvite
(b) cysteine and calcium oxalate
© cysteine and calcium phosphate
(d) cystine and uric acid
(e) struvite and calcium oxalate

[ArchivalUser]

any one.
what happen to the pH of the urine to the pt with RTA

[ArchivalUser]

RTA-I is associated mainly with calcium phosphate stones
and the pH is always above 5.5

[ArchivalUser]

urine of the pt with RTA is alkaline because pt can loss H+ through the urine.
struvite, calcium oxalate, calcium phosphte develop at alkaline environment.

[ArchivalUser]

pH is only one factor in the pathogenesis of a stone
Struvite stones for example require upper urinary tract infection with a urease-producing organism, not just an alkaline urine.
Calcium oxalate which is the most common form of calcium stones will form in alkaline urine but other risk factors or causes of hyperoxaluria are required such as inflammatory bowel disease and/or malabsorption or primary hyperoxaluria.
But in case of isolated RTA type one, alkaline pH is one factor, but the main factor is the ACIDEMIA which leads to bone buffering (to buffer the excess acid) by releasing calcium phosphate from the bone and increase their level in the urine.

[ArchivalUser]

i understand what are you saying.
i just give this question to know which stone would form at the alkaline environment and which one would form at the acidic environment. uric acid and cysteine does not form at the alkaline environment.