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Abdomen 2 > Cystic Diseases > Flashcards

Cystic Diseases Flashcards

1
Q

What is the definition of a cyst

A

Walled off collection of fluid

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2
Q

Does a true cyst have an epithelial wall

A

Yes

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3
Q

True cysts are

A

Congenital

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4
Q

What are the two different components of congenital true cysts

A

Hereditary

Developmental

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5
Q

Do acquired cysts have an epithelial wall

A

No

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6
Q

What are the 2 categories of cysts

A

True

Acquired

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7
Q

What period can acquired cysts occur

A

Post traumatic events
Infectious
Parasitic
Inflammatory (abscesses)

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8
Q

What are the features of a true cyst

A

Multiple cysts in one organ

Multiple organs with cysts

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9
Q

What are the features of acquired cysts

A

A patient’s: history, signs and symptoms

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10
Q

What are the 4 sonographic requirements for a simple cyst

A

Anechoic
Strong back wall
Posterior enhancement
Oval or round -> refractive edge shadowing

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11
Q

What is the 4 criteria for complex cysts

A

Internal echoes
Septations
Calcifications
Thick wall or mural nodularity

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12
Q

Internal echoes are usually indicative of what

A

Hemorrhage

Infection

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13
Q

Septations are usually indicative of what

A

Malignancy
Hemorrhage
Infection
Adjacent cysts

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14
Q

Calcifications are indicative of what

A

Malignancy
Inflammatory reaction
Milk of calcium

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15
Q

Thick wall or mural nodularity is indicative of what

A

Malignancy

Benign thickening

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16
Q

age increases occurance of cysts where

A

liver

kidneys

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17
Q

cysts are

A

common, often incidental finding in an abdominal scan

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18
Q

multiple cysts can indicate what

A

genetic abnormality

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19
Q

possible effects are dependent of

A

number
size
location

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20
Q

possible effects

A 
asymptomatic
pain
pressure
increased lab values
jaundice
fever
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21
Q

majority of cysts are

A

asymptomatic

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22
Q

what are the two types of renal cortical cysts

A

simple

complex

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23
Q

simple renal cortical cysts are

A 
benign 
have unknown etiology
increase with age 
mostly asymptomatic 
no required follow-up
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24
Q

complex renal cortical cysts do

A

not meet criteria of a simple cyst
requires further imaging
has septations

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25
Q

if a complex renal cortical cyst has irregular >1 mm septations or solid elements is present what must be presumed about the lesion

A

malignant until proven otherwise

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26
Q

PKD

A

polycystic kidney disease

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27
Q

what are the 2 types of PKD

A

autosomal dominant

autosomal recessive

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28
Q

ADPKD

A

autosomal dominant polycystic kidney disease

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29
Q

ADPKD is the most common

A

hereditary renal disorder

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30
Q

ADPKD manifest in

A

4th decade of life

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31
Q

what are the associated anomalies of ADPKD

A

liver, pancreas and splenic cysts

cerebral berry aneurysms

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32
Q

50% of people with ADPKD develop

A

renal failure

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33
Q

what is the presentation of ADPKD in patients

A 
palpable mass
pain
hematuria
hypertension
UTI's
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34
Q

what is the sonographic appearance of ADPKD

A

renal enlargement

multiple bilateral cysts

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35
Q

does ADPKD always effect both kidenys

A

yes

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36
Q

what is the most sensitive lab test for kidneys

A

creatine and then BUN

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37
Q

how do you measure ADPKD kidneys

A

overall size and look for malignant features

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38
Q

how does the presentation of ADPKD differ from cortical cysts

A

there is multiple cyst and they are in the sinus and medulla`

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39
Q

ARPKD

A

autosomal recessive kidney disease

40
Q

what are the 4 ages that are effected by ARPKD

A

perinatal
neonatal
infantile
juvanile

41
Q

in ARPKD younger children what is more prominent

A

renal abnormalities

42
Q

in ARPKD older children what is more prominent and what kind

A

liver abnormalities, more so portal hypertension

43
Q

what are all cases of ARPKD associated with

A

congenital hepatic fibrosis

44
Q

what is the sonographic appearance of of ARPKD

A

massively enlarged echogenic kidneys
lose of CM differentiation
macroscopic cysts are also noted occasionally

45
Q

parapelvic cysts are

A

believed to be lymphatic in origin
located in the sinus
mostly asymptomatic

46
Q

what is the sonographic appearance of parapelvic cysts

A

well defined cysts

do not connect to the collecting system

47
Q

what can help differentiate between parapelvic cysts and hydronephrosis

A

a slow sweep, as parapelvic cysts will be walled off and not connect

OR

IVP/ contrast CT

48
Q

medullary sponge kidney are

A

dilated (ectatic) collecting tubules

49
Q

what percentage of patients with renal stones are found to have medullary sponge kidneys

A

12

50
Q

is the etiology of medullary sponge kidneys known

A

no

51
Q

when are medullary sponge kidneys typically identified

A

3rd and 4th decades of life

52
Q

what is the sonographic appearance of medullary sponge kidneys

A

bilateral echogenic pyramids

may have calcifications present, but localized to the pyramids

53
Q

`medullary cystic disease is

A

Genetic

result of progressive renal tubular atrophy

54
Q

what are the 2 types of medullary cystic disease

A

dominant

recessive

55
Q

medullary cystic always effects

A

the kidneys bilaterally

56
Q

what is the sonographic appearance of medullary cystic disease

A

echogenic kidneys
small measurement
0.1 - 1.0 cm pyramid cysts

57
Q

MCDK

A

multicystic dysplastic kidney

58
Q

MCDK is

A

developmental due to a obstruction of ureter in utero

non-hereditary and affects both male and females as well as both right and left kidneys

59
Q

MCDK is the most common renal cystic disease in what group of the poipulation

A

children

60
Q

what is the sonographic appearance of MCDK

A

small, malformed kidney
mulitple, non-communicating cysts
absence of normal renal architecture\
always presents clinically as unilateral

61
Q

what does bilateral MCDK cause

A

incompatibility for life and is only seen prenatally

62
Q

what is another name for primary congenital cysts

A

epidermoid cysts of the spleen

63
Q

primary congenital cysts are

A

rare

asymptomatic

64
Q

what is the sonographic appearance of primary congenital cysts

A

echogenic cystic structures

internal echoes

65
Q

choledochal cysts are found in

A

eastern Asian population

female predominantly

66
Q

what is a choledochal cyst and what is it caused by

A

fusiform dilation of the CBD and is caused by an anomalous insertion of the CBD into the pancreatic duct

67
Q

choledochal cysts have a known association with

A

cholangiocarcinoma (cancer of the bile duct)

68
Q

what is the sonographic appearance of choledochal cysts

A

cystic

can contain sludge, stones or solid neoplasm

69
Q

if a choledochal cyst is large it may be difficult to identify what

A

the connection to the bile duct

70
Q

what is the most common type of choledochal cyst

A

type 1

71
Q

what is Caroli’s disease

A

a rare, congenital dilation of the intrahepatic biliary tree

72
Q

what does Caroli’s disease result in

A

statis
stones
cholangitis
sepsis

73
Q

what is the sonographic appearance of Caroli’s disease

A

saccular or fusiform dilation of the intrahepatic bile duct

often diffuse, may be focal

74
Q

dilated ducts in Caroli’s disease often contain

A

sludge

stones

75
Q

Caroli’s disease has a connection with

A

ARPKD

medullary sponge kidneys

76
Q

what is cystic fibrosis and what abdominal organ does it effect

A

genetic condition
exocrine dysfunction

pancreas

77
Q

what is the sonographic appearance of cystic fibrosis

A

increased echogencity

atrophy

78
Q

in cystic fibrosis what is seen on pathology but uncommonly seen sonographically

A

small, 1-3mm, cysts

79
Q

peritoneal inclusion cysts are

A 
adhesion trapped ovarian fluid
ovary encased (trapped in the surrounding scar tissue)
more common in women
80
Q

what is the appearance of peritoneal inclusion cysts`

A

simple to complex

81
Q

mesenteric cysts are

A

rare
typically an incidental finding
variable in appearance and size

82
Q

what is the origin of mesenteric cysts

A

lymphatic or mesothelial

83
Q

GI duplication cyst are

A

filled with anechoic fluid
well defined
have a double layer wall

84
Q

what are the 2 layers of GI duplication cysts

A

Inner layer: mucosal layer -> echogenic

Outer layer: muscular layer -> hypoechoic

85
Q

what are the 2 types of prostatic cysts

A

degenerative

congenital

86
Q

what are degenerative prostatic cysts

A

most common
typically located in the transitional zone
have no clinical significance

87
Q

what are congenital prostatic cysts

A

most asymptomatic

associated with infertility and hematopspermia`

88
Q

what are the 4 types of congenital prostatic cysts

A

utricle
Mullerian duct
ejaculatory duct
seminal veslical

89
Q

what does a mullerian duct cyst cause and what does it look like

A

no spermatozoa

teardrop shape with a thick wall

90
Q

where is a utricle cyst located and look like and what is it associated with

A

midline, teardrop shape; usually small but can become large

unilateral renal agenesis

91
Q

what does a ejaculatory duct cyst look like and contain; as well as what is it associated with

A

fusiform shape
contains spermatozoa
associated with infertility

92
Q

what is a seminal vesicle cyst associated with

A

ipsilateral renal agenesis when increased in size

93
Q

in cystic diseases what happens to lab tests

A

LFT’s can be elevated and leukocytosis can be present

94
Q

in cystic diseases what can be done after identification

A

aspiration
biopsy
sent to other imaging modalities; such as CT or X-ray

95
Q

`what are the treatments for cystic diseases

A

aspiration
alcohol ablation
surgical removal
organ transplant

96
Q

what cystic diseases can cause abnormal LFT’s

A

Caroli’s
choledochal cysts
ARPKD

Abdomen 2 (6 decks)

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