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Medicine General 913b5bc9

Which of the following stones is hard to break by ESWL:

A
Calcium Oxalate Monohydrate
B
Calcium Oxalate Dihydrate
C
Uric acid
D
Struvite
High-Yield Explanation
Answer is A (Calcium Oxalate Monohydrate): Calcium Oxalate Monohydrate Stones (and cysteine) stones are very hard to break by ESWL. 'Very hard stones such as cysteine or calcium oxalate monohydrate are more likely to fail ESWL'. `Likelihood offragmentation with ESWL depends on stone composition. Less effective for stones composed of cystine or calcium oxalate monohydrate (very hard)' - Oxford handbook of urology (2005)/366 'Softer stones (calcium oxalate dehydrate, uric acid, apatite, and struvite) are more easily fragmented with SWL than are harder stones (calcium oxalate monohydrate, brushite, and cystine) -

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