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CPR M2T1E3 > #11 Katz - Imaging of the Kidney and Renal System > Flashcards

#11 Katz - Imaging of the Kidney and Renal System Flashcards

1
Q

List the three areas of constriction.

A
  1. Uteropelvic junction
  2. Pelvic inlet
  3. Uterovesical junction
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2
Q

You are working in a small rural office and US and CT are not available. You want to perform imaging of the kidney. What are you likely to order?

A

Intravenous pyelogram (IVP)

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3
Q

You have ordered the IVP but what film should be done first and why?

A

Scout (flat) (KUB) abdomen so you can look for calculi. The contrast in the IVP would obscure the stones.

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4
Q

Which imaging would you order to look for calculi?

A

CT

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5
Q

In what situations would you not use contrast media in CT?

A

Allergies

Elevated BUN/Creatinine

Diabetic (If needed, keep well hydrated)

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6
Q

Identify

A

Phlebolith

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7
Q

Identify

A

Duplicated Collecting System

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8
Q

Identify

A

Horseshoe kidney

Corticomedullary differentiation

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9
Q

What are the advantages for using an ultrasound?

A

Non invasive

No radiation

Can detect hydronephrosis, renal masses & calcifications

Differentiating cysts from tumors

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10
Q

What type of resistance curve would be found on a Renal US in a patient with renal failure?

A

high resistance curve

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11
Q

What disease has been associated with the use of gadolinium-based MRI contrast in patients with severe renal disease?

A

Nephrogenic Systemic Fibrosis

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12
Q

Identify

A

Right Renal Artery Stenosis

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13
Q

Identify

A

Right Renal Artery Stenosis

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14
Q

Your patient has fractured a transverse process in the lower thoracic area. What test should you order and why?

A

Urine analysis and imaging to check for ureter injury

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15
Q

Identify. What other image would you take?

A

Possible Renal Agenesis

Pelvic image to look for pelvic kidney

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16
Q

Identify

A

Pelvic Kidneys

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17
Q

Identify

A

Horseshoe Kidney

Calyces pointing in different directions

Abnormal orientation

Kidneys not along psoas shadow

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18
Q

When noticing dilated calyces, what could be a cause?

A

Duplicated ureters

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19
Q

Identify

A

Ectopic Ureterocele

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20
Q

What is the normal size of the kidney?

A

10-14 cm

21
Q

Identify

A

Ureteral Reflux

22
Q

What imaging has replaced IVU as the imaging modality of choice for detecion of urinary stones?

A

CT

23
Q

Identify

A

Phlebolith with tail

CT

24
Q

Identify

A

Renal Calculi near calyx

Low atherosclerosis of the aorta

25
Q

Identify

A

IVP with partial obstruction

26
Q

Patient presents with colicky flank pain with intermittent hematuria. What do you suspect?

A

Urinary stones

27
Q

Identify

A

Staghorn Calculi

Struvite Stones

UTI

No contrast (obscured w/contrast)

28
Q

Identify

A

Hydronephrosis

Calculi (seen on bottom image)

29
Q

What treatment can be used to break up calculi over 5 mm?

A

Lithotripsy

ESWL (Extra Corporeal Shock Wave)

Kidney, Ureter or Bladder stones

30
Q

What is the cell type of ureteral tumors?

A

transitional cell

31
Q

Identify

A

Transitional Cell Carcinoma

(If it’s in the collecting system TCC)

32
Q

Identify

A

Goblet deformity

Transitional Cell Carcinoma

33
Q

Identify

A

Renal Pelvic Tumor

Would need to know there was contrast

Could use HU to differentiate (Calcium 1000)

34
Q

Identify

A

Dilated Renal Pelvis - Newborn

Unilateral - UPJ obstruction

35
Q

Medial uretal displacement might indicate?

A

Retroperitoneal mass

36
Q

What is the most common renal mass?

A

Renal Cyst

37
Q

What is a worrisome characteristic of a mass?

A

Calcification

87% with central and irregular calcification –> RCC

20% peripheral calcification –> RCC

ENHANCEMENT following contrast administration

38
Q

You see the presence of fat in the kidney. What is the likely diagnosis? Benign or malignant?

A

Angiomyolipoma

Benign

39
Q

On US, a renal cyst will show what characteristics?

A

Sharp interface between cyst and renal parenchymy

Round or Oval, anechoic (black)

Thin wall

Increased sound transmission

40
Q

Identify

A

Renal Cyst

41
Q

Identify

A

AD-PKD

42
Q

A 53 year old patient presents with hematuria, flank pain and a palable mass. What do you suspect?

A

Renal Cell Carcinoma

43
Q

What are the risk factors for renal cell carcinoma?

A

Modifiable:

Smoking

Obesity

Analgesics

NonModifiable:

Male

von Hippel-Lindau disease

Family History

Chronic dialysis

44
Q

Identify

A

Renal Cell Carcinoma (Adenocarcinoma)

Not a cyst

Does not enhance like the normal kidney

Not uniform

45
Q

Identify

A

Adenocarcinoma [RCC]

(Ultrasound)

Mass

Not cystic

46
Q

3.5 year old presents with an abdominal mass. What do you suspect?

A

Wilm’s tumor

47
Q

Identify

A

Wilm’s Tumor

48
Q

Renal Abscess is usually a complication of what gram negative infection?

A

E. Coli

49
Q

Identify

A

Renal Laceration

CPR M2T1E3 (20 decks)

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