Calcifications I

Question 1

where is normal calcification in structures seen

Answer 1

-costal cartilages
-mesenteric lymph nodes
pelvic vein clots (phleboliths)
prostate gland

Question 2

what are abnormal calcification locations

Answer 2

pancreas
renal parenchymal tissue
blood vessels
gallbladder
vas deferns

Question 3

what are the 4 major patterns of calcifications

Answer 3

1. concretions/calculi (stones)
2. Conduit wall (tube structure)
3. Cyst wall
4. solid mass

Question 4

concretion (stone) apperence (shape, borders, internal appearance)

Answer 4

shape- round/oval/faceted

borders- sharp, well defined, continuous/uninterupted

Internal app- laminated, homogenous

Question 5

concretion types

Answer 5

gallbladder (gallstones)
urinary tract
diverticulum
pelvic veins (phleboliths)
pancreas
prostate

Question 6

What is a phelbolith, mc loc and management

Answer 6

deposits of calcium within wall of vein

common in pelvic area (generally asymptomatic, no need for follow uo)

Question 7

how to differential phlebolith from ureter caliculi

Answer 7

if depends bellow ischial line prob not ureter calculi

Question 8

what is a fecolith/appendicolith and where is it found/why

Answer 8

stagnent feces
seen in 10% of acute appendicitus
seen in 1/3 of removed appendices

(risk of rupture/surgerical removal)

Question 9

gallstones (two types and pt it presents in)

Answer 9

cholesterol or bile

mc in women over 40
4Fs (female, fat, forty,fertile)

80% asymptomatic

Question 10

risk factors of cholelithiasis

Answer 10

hemolytic anemoa
liver cirrhosis
diabetes
organ transplant

Question 11

cholelithiasis imaging choice and tx

Answer 11

Ultrasound isn preferred

tx- surgery

Question 12

What is gallstone ileus

Answer 12

gallstone in ileocecal valve leads to multiple loops of stacked small bowel distention

Question 13

What is milk of calcium and how will it look

Answer 13

Sequele of cholecystitis
calcified biliary sludge within lumen of gallbladder
(gallbladder will be outlines

Question 14

what are the two main kidney calcification pattens and what do they mean

Answer 14

Nephrolithoasis- Intralumental (stone)

Nephrocalcinosis- intraparenchymal (in parenchymal tissue)

Question 15

imaging signs of nephrolithiasis vs nephrocalcinosis

Answer 15

nephrolithiasis- dense cal near central region

Nephrocalcinosis- Small rounded stones around parenchyma

Question 16

Nephrocalcinosis pres + signs

Answer 16

medullary> cortical
Usually bilaterally

no early symptoms
similar symptoms to kidney stones (fever, pain nausea)

Question 17

what can nephrocalcinosis lead to

Answer 17

later may develop kidney failure

Question 18

Nephrocalcinosis tests + referal

Answer 18

Abdominal CT/US

Lab- Serum calcium, phosphate, uric acid and parathyroid hormone increased

Question 19

Urinary calculi près and symptoms

Answer 19

intraluminal solid particles within the urinary system
symptoms: pain, nausea, commuting
check for blood in urine

Question 20

Nephrolithesis symptom referral pattern

Answer 20

pain referral pattern flank into the abdomen and later the groin

Question 21

Nephrolithiasis risk factors

Answer 21

Fam hx
UTI
kidney disorders
hyperparathyroidism

Question 22

urinary calculi dx tests + tx

Answer 22

xray, CT

tx- h20, analgesics, antibiotics, surgery

Question 23

Nephrolithiasis imaging pres

Answer 23

85-90% contain calcium
retroperitoneal loc
risk of obstruction

Question 24

What is a stag horn calculus and what does it look like

Answer 24

large branching calculi

located in pelvicalyceal system (won’t pass)

Question 25

Why do staghorn calculi form and symptos

Answer 25

commonly struvite forms in high Ph urine

more common in women

ss- fever, flank pain, hematuria

Question 26

tx of stag horn calculi

Answer 26

• referal to nephrologist*
• entire stone must be removed *surg)
• if untx leads to chronic kidney inf and may result in pyelonephritis

Question 27

Bladder calculi look and causes

Answer 27

smooth/irregular edges (usually a bit bigger

• urinary bladder outlet obstruction (mc)
• Recureent bladder inf
• Neurogenic bladder
• foreign bodies

Question 28

bladder calculi symptoms

Answer 28

asymptomatic to painful

dysuria, frequency, hesitation, hematuria

tx- surgical removal

Question 29

Who are prostatic calculi common in

Answer 29

> 40
overlie symphysis pubis
hx of prostatic