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Chapman Aids to differentials flashcards > Adrenals, urinary tract, testes and prostate > Flashcards

Adrenals, urinary tract, testes and prostate Flashcards

1
Q

adrenal mass sizing for benignvs malignant

A

3cm

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2
Q

if adrneal lesion is <10HU

A

lipid rich - adenoma

benign

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3
Q

washout values for adrneal lesions

A

Relative wahsout over 40% - lipid poor adenomas

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4
Q

Types of functioning adrenal tumours

A

Conns

Phaeo

Cushings

Adrenal carcinoma

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5
Q

Functioning adenomas are likely to be lipid poor or pipid rich?

A

lipid rich

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6
Q

size of phaeo normally

A

large

> 5cm

enhance, necrotic

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7
Q

Cushings adenoma size

A

normally bigger than 2cm.

most of Cushings syndrome is from pituitary adenoma or ectopic source with hyperplasia of adrenal resulting

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8
Q

signs of cushings adenoma

A

atrophy of the other adrenal gland

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9
Q

features of adrenal carcinoma

A

rare and large

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10
Q

neuroblastoma does what to vessles

A

surrounds and displaces without causing narrowing

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11
Q

non functioning adenomas

size and enhancement

A

homogenous enhancement, <2cm

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12
Q

adrenal haemorrhage cahrachteristics

A

high attenuation on non contrasdt

in severe truama

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13
Q

adrenal cysts appearance

A

round, well define ect

if multilocualted think - lymphangioma and hydatid cyst

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14
Q

features of adrenal granulomatous disease

A

Bilateral

think TB, histoplasmosis

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15
Q

Bilateral adrenal masses

A

mets

phaweo

adenomas
\hyperplasia (CAH in kids)

haemorrhage

Granulomatous disease - central nec

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16
Q

adrenal calc

A

previous haemorrhage

cystic disease

chronic TB/histoplasmosis

part of tumour

addisons (likely infective rather than autoimmune)

Wolman disease

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17
Q

what is wolman disease

A

rare auto rec lysosoaml acid lipase deficine t

enalrged adrenals
fatty liver and spleen

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18
Q

Congenital renal anomalies

broadly, different types

A

position

form

number

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19
Q

renal anomalies of position

A

ectopic - pelvic

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20
Q

anomalies of form

kidney

A

Horseshoe

Crossed reanl ectopia (l–>R)

Pancake

Renal hypoplasia

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21
Q

Horseshoe AX

A

many

but remeber Turners

more likely to get Wilms, TCC, RCC

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22
Q

renal

anomalies of numer

A

Unilateral agenesis - VACTERAL, mullerian ducts, Zinner syndrome

Potter syndrome - bilat absent

Supernumerary kidney - rare, left side

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23
Q

what is Zinner syndrome

A

men

renal agenesis, ipsilateral seminal vesicle cyst, ejaculatory duct obstruction

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24
Q

Bulgin of renal outline. - different types

A

cyst / multiple cysts
Tumour
Dromedary hump
Septum of bertin
Hilar lip
Pseudotumour in reflux
Duplex kidney
dilatation of a single calyx

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25
Pseudotumour in reflux nephropathy - why
hypertrophy of the unscarred renal parenchyma
26
appearance of an enlarged septum of Bertin
betwene upper and interpolar region Pseudomass with calyceal splaying and associated short calyx duplication Normal echogenicity or increase. CT similar to normal cortex
27
Appearance of a duplex
hydronephrotic upper moiety. delayed films have contrast in the upper moiety. lower moiety - drooping lilly appearance
28
unilateral scarred kidney shapes
Fetal lobulation duplex spleen impression reflux nephropathy lobar infarction
29
unilateral scarred kidney causes
reflux nephropathy Tuberculous autonephrectomy - calc! lobar infarction renal dysplasia - lots of cysts
30
unilateral small smooth kidney general list of causes
post obstructive, ischaemia and post inflammatory
31
unilateral small smooth kidney Pre-renal vascular vasues
Ischaemia from RAS Radiation nephritis Renal infarction
32
unilateral small smooth kidney Renal causes
Congenital hypoplasia Multicystic dysplastic kidney Papullary necrosis Post inflammatory Following partial nephrectomy
33
unilateral smooth small kidney post renal causes
collecting system issues post obstructive atrophy
34
Bilateral small smooth kidneys causes by Pre renal Reanl Post reanl
Arterial hypotension Generalaized arteriosclerosis chronic glomerulonephritis Hereditory nephropathies Chronic papillary necrosis
35
unilateral LARGE smooth kidney most common causes are
duplex kidney compensatory hypertrophy obstruction
36
unilateral LARGE smooth kidney pre renal causes
Acute renal vein thormbosis Acute arterial infarction
37
unilateral LARGE smooth kidney reanl casues
Duplex Hypertrophy compensatory Fused ectopia Diffuse infiltrative tumour Malakoplakia
38
what is malakoplakia ?
rare chronic granulomatous inflammatory disease soft yellow plaques
39
bilateral large smooth kidneys
Developmental - Bilateral duplex kidneys - ARPKD Inflammationv - acute glomerulonephritis - ATN - Acute cortical necrosis - Acute interstitial nephritis - Polyarteritis nodosa Deposition of abnormal proteins - Amyloid - MM Neoplastic infiltration - leukaemia and lymphoma Miscellaneous - Bilateral hydronephrosis - Acute renal papillary necrosis - Acute uric acid nephropathy - early diabetic nephropathy - sickle cell - HIV assocaited nephropathy - Acromegaly
40
Causes of dystrophic calcification due to localized disease
Infections - chronic pyelo - TB - Xanthogranulomatous pyelo - Hydatid
41
what are the HU of renal calculi that could then be seen on abdo radiograph
>500HU
42
renal calculi mimics in the kidney
vascular (surrounded by renal sinus fat) Randalls plaques
43
causes of medullary nephrocalcinosis
Nedullary sponge kidney HyperPTH Renal tubulour acidosis Renal papillary acidosis Renal papillary necrosis Causes of hypercalcaemia or hypercalciuria Pre term neonates Hyperoxaluria
44
causes of cortical nephrocalcinosis
Acute cortical necrosis chronic glomerulonpehritis chronic infection chronic renal tranplant rejection hyperoxaluria alport syndrome
45
renal cystic disease renal dysplasia
MCDK Localised cystic renal disease
46
renal cystic disease Polycystic kideny disease
ARPKD ADPKD
47
reanl cystic disaese cystic tumours
mutlilocular cystic nephroma (Mj lesion) Multilocular cystic RCC Mixed epithelial and stromal tumour Angiomyolipoma with epithelial cysts Primary reanl sarcoma Cystic wilms tumour
48
cortical cysts
simple syndromic - VHL, follow cysts up - TS End stage CKD lithium glomerulocystic kidney disease
49
Medullary cysts
Calyceal diverticulum Medullary sponge kidney Papillary necrosis Medullary cystic disease complex
50
list bozniak classification
1 - water, no enhancement, no wall, no septa, no solid component no fu 2 - thin septations, fine calcification only. 2F - thickened septa, or thick calc. (US/ CT) 3 - measurable enhacnement
51
fat containing renal mass
AML RCC Liposarcoma lipoma Oncocytoma Xanthogranulomatous pyeo Wilms Teratoma Renal sinus lipomatosis
52
solid renal lesions
RCC - multiple of bilateral in 3-5%. oncocytoma fat poor aml haemangioma leiomyoma Juxtaglomerular cell tumour Metanephric adenoma Medullary fibroma Papillary adenoma Sarcomas Pseudotumours
53
Infiltrative renal lesions
TCC SCC infiltrative RCC Lymphoma Metastases Leukaemia Malakoplakia Sarcomas
54
Non neoplastic renal lesions
Peripelvic cyst Parapelvic cyst sinus lipomatosis vascular inflammatory haematoma urinoma rare infiltrative disorder
55
neoplastic and proliferative disorders of the perinephric space soft tissue rind
Lymphoma Erdheim chester disease Amyloidosis retroperitoneal fibrosis Metastases Extramedullary haematopoiesis Rosai-Dorfman disease Nephroblastomatosis
56
neoplastic and proliferative disorders of the perinephric space focal solid lesions
Renal lesions extending outward mets perinephri haematoma ndoular fat necrosis in pancreaitis primary sarcoma
57
neoplastic and proliferative disorders of the perinephric space fatty lesions
Exophytic angiomyolipoma liposarcoma perinephric lipomatosis extraadrenal myelolipoma
58
neoplastic and proliferative disorders of the perinephric space cystic lesions
exophytic renal cyst urinoma lymphangiomatosis
59
nephrographic patterns
corticomedullary phase - 25-80s nephrographic phase - 90-120s excretory phase - 3mins+
60
Nephrographic patterns Absent nephrogram
Global - renal artery occlusion Segmental - focal infarction (embolic or vasculitic) capuslar enhancement indicates infarction
61
unilateral delayed nephrogram
Obstructive uropathy reduced arterial inflow reduced venous outflow pyelonephritis
62
bilateral persistent nephrogram
reduced arterial inflow abnormal renal tubules bilateral obstructive uropathy Reduced venous outflow
63
Unilateral striated nephrogram
Acute ureteruc obstruction acute pyelonephritis renal vein thrombosis traumatic reanl contusion
64
Bilateral striated nephrogram
acute pyelo abnormal renal tubules hypotension medullary sponge kidney autosomal recessvie PCKD
65
Spotted nephrogram
Vascultiis multiple emboli pyelonephritis
66
reverse rim nephrogram
only medulla and renal capsule enhancing - acute crotical necrosis
67
MRI diffuse low signal in the renal cortex
Paroxysmal nocturnal haemoglobinuria Mechanical haemolysis Severe sickle cell disease Renal cortical necrosis
68
Types of renal papillary necrosis
Swollen Partial Total Necrosis in situ
69
renal causes of hypertension
Renal artery stenosis Chronic bilateral parenchymal disease chronic reflux nephropathy tumours producing renin chronic renal infection renal vein thrombosis radiotherapy
70
features of RAS on US
peak systolic velocity over 200cm/s 60% stenosis turbulent flow
71
Causes of Renal Artery Stenosis
Atherosclerosis - prox 2cm Fibromuscular dysplasia - women, string of beads. often bilateral. Renal artery dissection - extension from aorta dissection Arteritis - PAN. GPA - Takyasu - can cause stenosis - Takayso Neurofibtomatosis - rarely Midaortic syndrome
72
Non opacification of a calyx on CT or excret urography
Technical Tumour (RCC/ WIlms) Obstructed (Calc/Tumour/TB) Duplex kidney infection partial nephrectomy
73
filling defect in the renal collecting system or ureter Extrinisic with a smooth margin
renal sinus masses Vascular impression Renal sinus lipomatosis
74
filling defect in the renal collecting system or ureter arising from the wall - with smooth margins
Early urothelial cancer papilloma Pyeloureteritis cystica metastases suburothelial haemorrhage endometriosis pseudodiverticulosis steven-johnson syndrome
75
filling defect in the renal collecting system or ureter arising from thw wall with an IRREGULAR margin
urothelial carcinoma SCC RCC Squamous metaplsia TB Malakoplakia Amyloidosis Sarcoidosis
76
filling defect in the renal collecting system or ureter WITHIN THE LUMEN
Calc Blood clot Air bubble Sloughed papilla Benign fibroepithelial polyp Fungus ball
77
Spontaneous urinary contrast extravasation
pyelosinus backflow pyelotubular backflow pyelointerstital backflow Pyelolymphatic backflow Pyelovenous backflow
78
collecting system dilatation Dilated calyx ith a narrow infundibulum
Stricture Xanthogranulomatous pyelonephritis Infiltrative proxesses of the renal sinus Extrinisc compressino by an artery Calcyceal diverticulum
79
collecting system dilatation Dilated calyx with a WIDE infundibulum
Chronic reflux papillory necrosis - clubbed congenital megacalyces
80
collecting system dilatation Dilated calyx with a NORMAL infundibulum
normal variant
81
collecting system dilatation Dilated calyx and renal pelvis with a normal ureter
Congenital PUJ obstruction Acquired PUJ obstruction - all causes Pelvicalcyceal cysts - hard to diff from hydronephrosis on US. Extretory phase CT diagnostic.
82
Dilated ureter causes from WITIHIN the wall
Stricture / Oedema Primary tumour (TCC/Papilloma) Mets Post surgery TB striucture - multifocal Schisto - distal +calc++ Ureterocoele radiation ureteritis malakoplakia amyloidosis vasculitis Primaryobstructive megureter congenital midureteric stricture
83
Dilated ureter outside the wall
retroperitoneal fibrosis malignancies Strictures from inflammation endometriosis extrinsic compression from benign pelvic masses retrocaval ureter
84
dilated ureter Causes not from obstruction or reflux
Pregnancy Residual post relief Polyuria Urinary tract infection Primary nonobstructive megaureter
85
deviation of the ureters medial
Fibrosis normal variant due to large iliopsoas muscle Retrocaval ureter (right only) Pelvic lipomatosis (men) - pear shaped bladder sidewall mass
86
deviation of the ureters lateral
Hypertrophy of psoas muscles (upper ureter laterally) retroperitoneal mass pelvic mass aneurysmal aortic dilatation postoperative prune - belly syndrome
87
retroperitoneal mass solid
Lymphoma Mets to lymph nodes (kidneys, testes, cervix, porstate) Infection (TB or MAC) Sarcoid Castleman disease Rosai Dorfman disease Vascular Erdheim chester Extramedullary haematopoiesis Amylodosis Old renal transplant Sarcomas neurogenic tumours
88
retroperitoneal masses cystic
Lymphangioma Cystadenoma Epidermoid cyst Mullerian Cyst Cystic mesothelioma Cystic teratoma Lymphangiomyelolioma Bronchogenic cyst Dilated cisterna chyli Cystic change in a solid neoplasm Hydatid cyst Nonneoplastic - pseudo cyst, urinoma, lymphocele, haemtoma, abscess
89
retroperitoneal masses fat containing
Liposarcoma Angiomyolipoma Retroperitoneal fat necrosis perinephric lipomatosis lipoma teratoma Hibernoma (prominent feeding vessel) - high PET uptake Extrameduallary haematopoiesis Others
90
Retroperitoneal fibrosis
idiopathic (70%) ?IgG4 2ary - Retroperitoneal malignancy - retroperitoneal haemorrhage - inflammatory conditions - connective tissue diseases - drugs (dopamine agonists, hydralazine, b blockers) - radiotherapy
91
Bladder filling defect or mass IN THE LUMEN
Clac foreign body blood clot Ureterocoele fungus ball
92
Filling defect or mass ARISING FROM THE WALL MALIGNANT
Malignant neoplasms - Urothelial cacrinoma (Polypoid or papillary projecting into the lumen) - SCC - Adeno, persistent urachus. - mets - sarcoma (rare, by rhabdomyosarcoma in kids) -Neuroendocrine - carcinoid/small cell -melanoma
93
Filling defect or mass ARISING FROM THE WALL BENIGN neoplasms
Papilloma Leimyoma Neurofibroma Paraganglioma Haemangioma Solitary fibrous tumour
94
Filling defect or mass ARISING FROM THE WALL Inflammatory conditions
Nephrogenic adenoma cystitis cystica malakioplakia infalmamtory peseudotumour esoinophilic cystitis
95
Filling defect or mass ARISING FROM THE WALLTRINSIC
Prostate enlargement Pelvic masses enlarged uterus Inflamation adjacent to the bladder wall iliac artery aneurysm Colonic distension urachal cyst or mass endometriosis
96
diffuse bladder wall thickening Inflammatory
cystitis TB Schisto Malakoplakia
97
diffuse bladder wall thickening muscle hypertrophy
Chronic bladde routlet obstruction neurogenic bladder - Upper motor neurone damage only
98
diffuse bladder wall thickening Neoplastic
Signet ring andeocarcinoma mets lymphoma plexiform neurofibroma
99
Bladder calcification in the lumen
calc foregin body tumour - TCC, SCC, paraganglioma, Alkaline encrusted cystitis
100
Bladder calcifcaiton in the wall
Schisto TB Chronic radiation tumour - mucinous adneocarcinoma amyloidosis
101
Bladder fistula causes Congential inflammatory Neoiplastic Trauma
Congential - bladder exstrophy -imperforate anus - patent urachus inflammatory - diverticular disease - crohns - appendix abscess - TB Neoplastic - carcinoma of the colon, bladder, reproductive organs - radiotherapy Trauma - accidental - iatrogenic
102
gas in the bladder wall
Emphysematous cystitis - diabetics, e coli
103
Urachal lesions Congential infection Malignancy
Congenital - patent urachus, leaking of urine - urachal cyst , focal patency fluid filled cyst - urachal sinus - vesicourachal diverticulum infection - S aureus, E. Coli. Malignancy - Adeno, mostly mucinous
104
Calcification of the male genital tract Seminal Vesicles and vas deferens
DM Chronic infection Seminal Vesicle duct calculi
105
Prostate Calcifications
benign can be due to chronic prostatitis cancer - if in the peripheral zone seed brachytherapy
106
scrotum calcifications
testicular microlithiasis scrotal pearl Prior trauma Clacification in a mass lesion Sperm granuloma End stage renal failure
107
Penis Calcifications
Peyronis disease End stage renal failure
108
Prostatic lesions Solid
Benign prostatic hyperplasia Prostatic adenocarcinoma Benign mimics of prostate cancer Secondary malignancy Rare prosate neoplasms
109
MRI charachteristics of Prostatic adeno
T2 low, DWI restriction and early enhancement with washout
110
how to distinguish prostate adeno from recent biopsy
T1 from haemorrhage - will diasppear after 6 weeks. both will be t2 low
111
prosatic lesions Cystic by location
MIDLINE - Utricle cyst - mullerian duct cyst - ejaculatory duct cyst -cowpers duct cyst LATERAL - cystic degeneration of BPH - retention cyst - Abscess - Cavitary prostatitis - Cystic tumours - Hydatid - rare
112
Seminal vesicle abnormalities
Congenital Tumour invasion Iatrogenic changes infection amyloidosis primary seminal vesicle tumours hydatid
113
ultrasound of intratesticular abnormalities neoplastic
painless Germ cell tumours - Seminoma - homogenous hypoechoic - nonseminomatous - aggresive , cystic - epidermoid cyst - onion skin sex cord stromal tumours - Leydig or sertoli Lymphoma Mets Cystadenoma of rete testis
114
sertoli tumours have ax with
Carney complex peuts Jaggers
115
Non neoplastic cysts intratesticular
Tubular ectasia of the rete testis simple cyst intratesticular varicocele (mimic)
116
intratesticular abnormalities vascular
torsion segmental infarction - infeciton, trauma, vascultiis, sickle cell,
117
intratesticular abnormalities infective
Epidydymoorchitis Abscess Granulomatous infection
118
Testicular sarcoid
Multiple bilatearl small hypoechoic mases
119
Testicular liomatosis
multiple bialteral HYPERECHOIC lesions COWDENS
120
Ultrasound of extratesticular abnormalities in the epidydimys
Epidydimitis Spermatocele Epididymal cyst Postvasectomy ectasia Sarcoidosis Neoplasms - multiple
121
testicular abnormaliteis spermatic cord
varicocele Inguinoscrotal hernia lipoma hydrocele of the spermatic cord sperm granuloma spermatic cord haematoma leiomyoma sarcoma
122
extratesticular abnormalities paratesticular
Hydrocele Pyocele/haemtocoele Tunica albuginea Scrotal pearl Fibrous pseudotumour Malignancies of the periteonal origin
123
Male urethral stricture
trauma infeciton - long, gonoccal urethritis urethralccancer - scc commonly secondary urethral malignancy balantitis xeroticanobliterans congenital stricture benign urethral lesions
124

Chapman Aids to differentials flashcards (5 decks)

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