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NBME 23 Answers

nbme23/Block 2/Question#35

A 42-year-old man with a history of recurrent ...

Magnesium ammonium phosphate

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submitted by krewfoo99(40),

Image shows Stahorn Calculus

1) Staghorn Calculus in adults - Manesium Ammonium Phosphate 2) Staghorn Calculus in Children - Cystine

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submitted by chetzy(0),

increase ph shows its magnesium ammonium phosphate crystals.ph 7.3

bulgaine  The image shows a staghorn calculi which content is usually magnesium ammonium phosphate (can also be cystine but pH would be decreased not increased) and is caused by urease positive bugs that hydrolyze urea to ammonia leading to urine alkalinization (page 586 of FA 2019) +1  
nukie404  Patient also has a fever, suggestive of a UTI +