A 45-Year-Old Man Is Evaluated for Recurrent Urolithiasis

question 570

Multiple Choice

A 45-year-old man is evaluated for recurrent urolithiasis.  He underwent a Roux-en-Y procedure for morbid obesity two years ago.  He passed his first kidney stone one year ago and has passed several since then.  He has lost approximately 15 kg (33 lb) since the surgery and feels well otherwise.  His current medications include lisinopril for hypertension, esomeprazole for gastro-esophageal reflux disease, and a daily multivitamin.  He has no family history of kidney stones.
Which of the following factors is most likely responsible for this patient's kidney stone formation?

• A)High urinary oxalate and low urinary citrate
• B)Hypercalciuria
• C)Hyperuricosuria and low urine pH
• D)Low urinary volume
• E)Vitamin D deficiency

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Definitions:

Milgram Experiment

A psychological experiment conducted by Stanley Milgram in the 1960s to study obedience to authority, where participants were instructed to administer electric shocks to another person.

Stanford University Prison Experiment

A psychological study conducted by Philip Zimbardo in 1971 at Stanford University, where students were assigned roles of prisoners and guards to explore the effects of perceived power.

Generalization

Drawing a conclusion about a certain characteristic of a population based on a sample from it.

Logical Support

The provision of reasons or evidence to justify a claim or argument.