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Nephrolithiasis prevention — USMLE Step 3 MCQ

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ModerateAmbulatory Medicine / Primary CareNephrolithiasis preventionUSMLE Step 3

A 45-year-old man returns after passing a calcium oxalate kidney stone. He has had two stones in 3 years. Serum calcium and creatinine are normal. He drinks little water at work and eats a high-sodium diet. Urinalysis is normal today. Which of the following would you recommend at the follow-up visit?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: A — Increase fluid intake and reduce sodium intake

Higher fluid intake and sodium reduction lower recurrence risk for calcium stones; severe calcium restriction can increase oxalate absorption.

Reference: AUA Medical Management of Kidney Stones Guideline