Renal and Ureteric Stones

A 52-year-old woman from Bangalore with a history of recurrent urinary tract infections presents with acute right flank pain and fever (38.5°C). NCCT abdomen shows a 9 mm right ureteric stone at the mid-ureter with moderate hydronephrosis. Urine culture is positive for E. coli. Serum creatinine is 1.8 mg/dL (baseline 1.0 mg/dL). What is the most appropriate immediate next step in management?

A 35-year-old man presents with acute flank pain and is diagnosed with a 6 mm calcium oxalate ureteric stone. He is haemodynamically stable with no fever or signs of infection. What is the drug of choice for medical expulsive therapy?

A 42-year-old woman with recurrent calcium oxalate nephrolithiasis and hypercalciuria (urine calcium >300 mg/day) is being counselled on pharmacological prophylaxis. Which drug is the first-line agent to reduce stone recurrence?

A 42-year-old woman from Delhi presents with acute left flank pain, fever (38.5°C), and pyuria. CT abdomen reveals a 12 mm stone in the left proximal ureter with moderate hydronephrosis and perinephric stranding. WBC is 14,000/μL and creatinine is 1.8 mg/dL (baseline 0.9 mg/dL). What is the most appropriate immediate next step?

A 42-year-old woman with recurrent stone disease undergoes 24-hour urine analysis. Serum calcium and PTH are normal. Urine shows elevated oxalate (55 mg/day, normal < 40 mg/day) and normal citrate. Which single laboratory or clinical feature best distinguishes primary hyperoxaluria from idiopathic hypercalciuria?