MCQ 2

Q2. A 54-year-old male with acute lymphocytic leukemia develops a blast crisis. 
He is treated with intensive systemic chemotherapy. Following treatment,
the patient will be at increased risk for the development of
A. bile pigment gallstones
B. cholesterol gallstones
C. cystine kidney stones
D. struvite kidney stones
E. uric acid kidney stones 


Answer and explanation:


The correct answer is E.

Explanation:   Uric acid kidney stones in patients with leukemia are secondary to increased production of uric acid from purine breakdown during periods of active cell proliferation, especially following treatment. Vigorous hydration and diuresis are generally instituted after the diagnosis of acute leukemia is made. Uric acid kidney stones are also associated with inborn errors of purine metabolism, such as gout.
Pigment gallstones (choice A) are associated with hemolytic disease. The incidence of this type of gallstone is not increased in treated leukemias.
Cholesterol gallstones (choice B) are associated with diabetes mellitus, obesity, pregnancy, birth control pills, and celiac disease.
Cystine kidney stones (choice C) are rare; they are found in cystinuria.Struvite kidney stones (choice D) are associated with infection by urea-splitting organisms, such as Proteus