UKMLA PLAB AMC USMLE Prometric MCQ

Correct Answer: C

Explanation:
Patients with renal colic usually present with severe and sudden ureteral colic. In this case the pain was precipitated by the calculus being dislodged by the long and bumpy journey. In renal colic the pain is mediated through the autonomic nervous system. Since this is visceral pain, it is difficult to pinpoint the exact site of origin. The celiac ganglion innervates part of the gastrointestinal tract, as well as the kidney and the proximal half or two-thirds of the ureter; therefore, abdominal discomfort, nausea, and vomiting often accompany ureteral colic. Pain in which the patient can find no comfortable position is more likely to be renal or ureteral colic, whereas pain in which the patient wants to lie still is more likely to be related to peritoneal inflammation (eg, appendicitis, diverticulosis, salpingitis). Acute ureteral colic produces an agonizing, gripping pain that radiates intermittently from the loin to the groin, testicle, or labium, with a constant, less intense background colic. Stones can also cause intermittent or constant aching in the lumbar region