Nephrolithiasis and nephrocalcinosis — OSCE

OSCE communication and clinical reasoning station for the parents of an adolescent newly diagnosed with recurrent calcium oxalate stones and hypercalciuria, covering the diagnosis, the metabolic workup, the fluid and dietary prevention plan, the role of thiazide, and the safety-net.

osce communication and clinical reasoning station2 min readVerification in progress

Prompt

You have 8 minutes with the parents of a 13-year-old boy who has just passed his second calcium oxalate stone in two years. His metabolic workup shows idiopathic hypercalciuria with a normal calcium. The team has recommended a prevention plan of high fluid intake, dietary changes and possibly a thiazide diuretic. Explain why their son keeps forming stones, what the prevention plan involves day to day, why a thiazide might be added, and agree a safety-net.

Candidate brief

You are the paediatric registrar. The patient is 13 and has passed his second calcium oxalate kidney stone in two years, this time after an episode of colicky pain. His metabolic workup has confirmed idiopathic hypercalciuria with an otherwise normal blood panel. The consultant has asked you to explain to his parents why the stones keep recurring, what can be done to stop them, and what a thiazide diuretic would add. The parents are worried this will damage his kidneys and want to know if it is curable. Explain clearly, check their understanding, and agree a plan. ^[1]

References5Show

[1]Cao B; Daniel R; McGregor R; Tasian GE Pediatric Nephrolithiasis. Healthcare (Basel), 2023.PMID 36833086
[3]Singh P; Harris PC; Sas DJ; Lieske JC The genetics of kidney stone disease and nephrocalcinosis. Nat Rev Nephrol, 2022.PMID 34907378
[5]Gefen AM; Zaritsky JJ Review of childhood genetic nephrolithiasis and nephrocalcinosis. Front Genet, 2024.PMID 38606357
[10]Aldaqadossi HA; Shaker H; Saifelnasr M; Gaber M Efficacy and safety of tamsulosin as a medical expulsive therapy for stones in children. Arab J Urol, 2015.PMID 26413330
[11]Medairos R; Paloian NJ; Pan A; Moyer A; Ellison JS Risk factors for subsequent stone events in pediatric nephrolithiasis: A multi-institutional analysis. J Pediatr Urol, 2022.PMID 34980558

Nephrolithiasis and nephrocalcinosis — OSCE

osce communication and clinical reasoning station2 min readVerification in progress

Candidate brief

References5Show

[1]Cao B; Daniel R; McGregor R; Tasian GE Pediatric Nephrolithiasis. Healthcare (Basel), 2023.PMID 36833086
[3]Singh P; Harris PC; Sas DJ; Lieske JC The genetics of kidney stone disease and nephrocalcinosis. Nat Rev Nephrol, 2022.PMID 34907378
[5]Gefen AM; Zaritsky JJ Review of childhood genetic nephrolithiasis and nephrocalcinosis. Front Genet, 2024.PMID 38606357
[10]Aldaqadossi HA; Shaker H; Saifelnasr M; Gaber M Efficacy and safety of tamsulosin as a medical expulsive therapy for stones in children. Arab J Urol, 2015.PMID 26413330
[11]Medairos R; Paloian NJ; Pan A; Moyer A; Ellison JS Risk factors for subsequent stone events in pediatric nephrolithiasis: A multi-institutional analysis. J Pediatr Urol, 2022.PMID 34980558