CTC Gu

Question 1

Renal agenesis assoc

Answer 1

Unicornuate

Absent epi/vd or sv cyst

Question 2

Rcc

Answer 2

Enhances, calcifies, hypervascular and lytic mets

1. Clear cell 65-80% general pop, vhl, (ts earlier). 60% microscopic fat. Aggressive, hypervasc, often cystic
2. Papillary 10-15% hypovascular relative to cortex, dialysis, t2 dark (lipid poor aml, haemorrhagic cyst)
   Medullary aggessive sickle cell
3. 4-11% Chromophobe birt hogg dube
   Transolcation paeds post chemo

Staging
T1 <7cm
T2 >7cm
T3 extrarenal within gerota not adrenal. 3a renal vein, 3b abdo ivc 3c thoracic ivc
4 beyond gerota or into adrenal

Question 3

Retroperitoneum

Answer 3

Pelvic lipomatosis, liposarcoma (can look like lipoma), rhabdomyosarcoma, em haematopoiesis, lymphoma (lifts aorta), haemorrhage, rp fibrosis(medialises ureters), erdheim chester non lc histiocytosis - osteosclerosis, pulmonary ggo

Question 4

Bosniak

Answer 4

1- simple 0%
2-non enh high attn <3cm, hairline septae or thin calc 0%
2f-hyperdense >3cm or minimally thickened septae/calc 5%
3-thick septations, mural nodule, wall enh 55%
4-enh nodules 100% cancer

Question 5

Renal cysts

Answer 5

Adpkd - adults, liver cysts, cerebral aneurysms, no risk ca until dialysis, sv cysts, biliary hamartomas
Arpckd - congenital hepatic fibrosis, potter
Vhl - renal cyst, cc rcc, phaeo, panc net, panc serous cystadenoma and cysts, haemangioblastoma, est, cpp
Ts-aml, cc rcc younger, rhabdomyoma, tubers, sen, sega, lam, renal cysts

Lithium
Dialysis - get papillary cancer

Mcdk
Multilocular cystic nephroma protrudes into pelvis no enhancement

T2 dark cyst: papillary rcc, fat poor aml, haemorrhagic cyst

Question 6

Renal tb

Answer 6

Moth eaten calices - pap nec - cavities - infund8ibular stensoses caliectasis, kerr kink - generalised hydro
Calcs - putty kidney ?mesenteric calc nodes

Question 7

Papillary necrosis

Answer 7

Dm
Infection-pyelo, tb
Nsaids
Oxalosis
Sc
Analgesics
U - c - cirrhosis
Rv thrombosis

Question 8

Cortical nephrocalcinosis

Answer 8

Goat piss

Glomerulonephritis chronic
Oxalosis
Acute tubular necrosis - massive haemorrhage, burns
Transplant rejection

Pjp is a mimic

Question 9

Medullar nephrocalcinodis

Answer 9

Hyperparat
Acidosis RT
MSK- assoc caroli, BW, Ehlers danlos
Hypercalcuria
Oxalosis
Papillary necrosis

Question 10

Page kidney

Answer 10

Subcap HT - compression -Htn

Question 11

Post transplant collection

Answer 11

Early - ht t1 bright
Day 10 urinoma - mag3/dtpa, higher cr/k than blood
Weeks-months - abscess, rim enh/hypervasc
2/52-6/12 -lymphocoele, no tracer, cr/k =blood, sclerose dont drain can get femoral vein compression and oedema

Question 12

Renal transplant medical complications

Answer 12

All show increased RI >0.7, rejection shows decr mag3 flow and uptake, all show delayed excretion
HA rejection
Acute rejection - antibody and cell mediated - week 1
ATN - ischaemia during down time- week 1
Cyclospoine toxicity month
Chronic rejection - t cell mediated - months

Question 13

Renal tx vasc complications

Answer 13

Ra thrombosis - early (hepatic is late)
Ra stenosis >200cms, >2:1 pre-post stenosis, tardus parvus main renal artery hilum
Rv thrombosis - reversed diastolic flow renal a, first week

Can get avf and pseudoaneurysm post bx

Question 14

Aast renal trauma

Answer 14

1 sc haematoma
2 <1cm lac
3 >1cm lac, ht within perirenal space
4 lac into seg ra/v/collecting system, ht outside perirenal, seg infarct
5 shatteres, devascularised on main ra/v

Question 15

Urethra

Answer 15

Penile bulbar anterior - straddle
Membranous, prostatic - posterior - pelvic fracture

Delineation is urogenital diaphragm will see extraperitoneal vs perineal contrast on rug

Bulbar most commonly crushed under pubic symphysis in straddle injury-short stricture
Long stricture-gonococcal -also bulbous

Prostatic gets tcc rest scc
Female urethral divertic gets adeno