A patient presents to the emergency department with nausea and severe, colicky back pain that radiates into the groin. When asked to locate the pain, he points to the right costovertebral angle region
His physical examination is unremarkable. Which of the following lab tests is most important for the diagnosis?
A. Urinalysis
B. Serum electrolyte levels
C. Digital rectal exam
D. Lumbar x-ray
ANS: A
Urinary calculi can occur anywhere in the urinary tract; therefore, pain can originate in the flank or kidney area and radiate into the RLQ or LLQ and then to the suprapubic area as the stone attempts to move down the tract. The pain is severe, acute, and colicky and may be accompanied by nausea and vomiting. If the stone becomes lodged at the ureterovesical junction, the patient will complain of urgency and frequency. Blood will be present in the urine.
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