Nephrolithiasis and nephrocalcinosis — viva

Opening (must-hit)

"This is an uncomplicated ureteric stone — an 8 mm stone at the right vesicoureteric junction with hydronephrosis but no fever and no signs of sepsis or acute kidney injury. He is stable. My immediate management is analgesia with a non-steroidal anti-inflammatory drug, an antiemetic and hydration to correct dehydration, and I screen for the red flags: fever with obstruction, a solitary kidney, and acute kidney injury, none of which he has. Because the stone is distal and under 10 mm in an afebrile child, I would start medical expulsive therapy with tamsulosin and arrange outpatient review, with urology in reserve if it fails to pass. Once it is passed or removed, I arrange a full metabolic workup — stones in children are rarely a one-off event." ^[1][10]