The Anatomy of a Didactic Question
Which of the following is a risk factor for struvite urinary tract stones?
Answer choice options
- A. High urinary calcium
- B. History of gout attacks
- C. Male sex
- D. Recent urinary tract infection.
The incorrect options (distractors) are not totally wrong. These options can be diagramed as follows:
- D.Recent urinary tract infection.Struvite stones occur due to upper urinary tract infections caused by urease-producing organisms, such as Proteus or Klebsiella.
- A.High urinary calcium is a risk factor for calcium-based renal and ureteral stones. Urinary calcium is increased by high oxalate diets, low water intake, low calcium dietary intake, and calcium supplementation.
- B.History of gout attacks is a risk factor for uric acid-based stones.
- C.Male sex is a risk factor for calcium-based stones. Struvite stones are more common in women since women are more likely to have urinary tract infections.
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