Question:
Which of the following stones is hard to break by ESWL?
Which of the following stones is hard to break by ESWL?
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The dense monohydrate crystal resists shock waves; soft uric acid and struvite break easily.
Updated On: Jun 24, 2026
- Calcium oxalate monohydrate
- Calcium oxalate dihydrate
- Uric acid
- Struvite
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Verified By Collegedunia
The Correct Option is A
Solution and Explanation
Step 1: Understand ESWL fragmentation. Extracorporeal shock wave lithotripsy breaks a stone by focusing acoustic shock waves on it; how well a stone fragments depends on its hardness (composition) and density.
Step 2: Rank stone fragility. Soft, easily shattered stones include uric acid and struvite (and dihydrate calcium oxalate is relatively fragile). Hard, shock-resistant stones include calcium oxalate monohydrate (whewellite), brushite (calcium hydrogen phosphate) and cystine.
Step 3: Apply to options. Calcium oxalate monohydrate is dense and mechanically tough, so it resists fragmentation by shock waves and often needs more shocks, higher energy, or an alternative such as ureteroscopy with laser lithotripsy.
Step 4: Reject the distractors. Calcium oxalate dihydrate (weddellite) is more brittle and breaks more readily. Uric acid and struvite stones are soft and respond well to ESWL.
Answer: Calcium oxalate monohydrate (Option A).
Step 2: Rank stone fragility. Soft, easily shattered stones include uric acid and struvite (and dihydrate calcium oxalate is relatively fragile). Hard, shock-resistant stones include calcium oxalate monohydrate (whewellite), brushite (calcium hydrogen phosphate) and cystine.
Step 3: Apply to options. Calcium oxalate monohydrate is dense and mechanically tough, so it resists fragmentation by shock waves and often needs more shocks, higher energy, or an alternative such as ureteroscopy with laser lithotripsy.
Step 4: Reject the distractors. Calcium oxalate dihydrate (weddellite) is more brittle and breaks more readily. Uric acid and struvite stones are soft and respond well to ESWL.
Answer: Calcium oxalate monohydrate (Option A).
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