PAEA Surgery End Of Rotation (EOR) Practice Exam

Which of the following best describes the treatment options for nephrolithiasis to facilitate stone passage?

1. Use of NSAIDs and calcium channel blockers

2. Prescription of antibiotics and nephrotoxic agents

3. Exclusively surgical intervention

4. Bed rest and hydration therapy

The correct answer is: Use of NSAIDs and calcium channel blockers

The use of NSAIDs and calcium channel blockers reflects a well-established approach to facilitating stone passage in patients with nephrolithiasis. Nonsteroidal anti-inflammatory drugs (NSAIDs) help manage pain and may have a side effect of reducing ureteral spasm, which can aid in the passage of renal stones. Calcium channel blockers, particularly those like nifedipine, have been shown to relax the smooth muscle in the ureters, further promoting the passage of stones by decreasing ureteral tone and facilitating ureteral dilation. This combination of medications supports stone expulsion while managing discomfort, making it an effective treatment strategy for uncomplicated cases of nephrolithiasis. Other treatment options, such as surgical intervention, are typically reserved for more complicated cases or when conservative management fails. Antibiotics and nephrotoxic agents are not appropriate for managing stone passage, as they do not address the issue directly and may have contraindications related to the condition. Bed rest and hydration therapy alone are not sufficient to promote stone passage effectively, though hydration is beneficial in the prevention and management of kidney stones overall.