Differential flashcards
DDx Hepatic metabolic liver disease (4)
Hepatosteatosis, amyloid, Wilson’s, hemochromatosis
Ddx Hypoattenuating liver (2)
Amyloid. Hepatosteatosis.
Ddx Dense liver (5)
Drugs (Amiodarone). Wilson’s. Hemochromatosis. Glycogen storage disease. Thorotrast
Ddx Hepatic infection (4)
Viral hepatitis, candidiasis, pyogenic, echinococcal cyst
Ddx Multiple tiny hypoattenuating liver lesions (5)
Candidiasis, lymphoma, mets, Caroli disease, Biliary hamartomas (von-Meyerburg)
Ddx Malignant hepatic lesions (5)
Epithelioid hemangioendothelioma, HCC, Fibrolamellar carcinoma, Lymphoma, mets,
Ddx Benign liver masses (3)
FNH, Hemangioma, hepatic adenoma
Ddx Hyperenchancing (vascular) liver mets (5) (‘neuroendocrine mets may shine right through)
Neuroendocrine, melanoma, Sarcoma, RCC, thyroid
Ddx Hypovascular liver mets (2)
Colorectal, pancreatic adenocarcinoma
Ddx liver mets w/ calcifications (2)
Mucinous colorectal, ovarian serous tumors
Ddx for capsular retraction of liver (6)
Mets, Fibrolamellar, HCC, epitheliod hemangioendothelioma, intrahepatic cholangiocarcinoma, confluent hepatic fibrosis.
Ddx Vascular liver disease (3)
Budd-chiari, veno-occlusive disease, cardiac hepatopathy.
Ddx Congenital cystic liver disease (3)
Biliary hamartomas (von moyenerg), ADPKD, Caroli.
Ddx Bile duct infection/inflammation (5)
Ascending cholangitis, PSC, PBC, Aids cholangitis, Recurrent pyogenic cholangitis.
Ddx Biliary neoplasms (4)
Biliary cystadenoma, cholangiocarcinoma, gallbladder carcinoma, gallbladder mets
3 categories of pancreatic neoplasms
Solid epithelial (2). Cystic epithelial (4). Endocrine neoplasms (5)
DDx for pancreatic mass w/ no ductal dilatation (8)
Autoimmune pancreatitis, groove pancreatitis, cystic pancreatic tumor, neuroendocrine tumor, Duodenal GIST, lymph node, mets, lymphoma
Differential for Solid mass in the tail of the pancreas (2)
Spen. Accessory spleen (1-3 cm, will follow spleen on all phases).
Differential for something enhancing in pancreas
Islet cell tumor. Splenic artery Pseudoaneurysm.
3 congenital pancreatic anomalies
Divisum, annular pancreas, common channel syndrome/pancreaticobiliary maljunction.
Systemic diseases that affect pancreas (4)
VHL, CF, Schwachman diamond, Obesity/steroid use (causes fatty atrophy)
Pancreatitis (4 types)
acute, chronic, autoimmune, groove
Ddx for bilateral delayed nephrogram (4)
bilateral obstruction, contrst nephropathy, systemic hypotension, myeloma kidney
Solid renal masses (6)
RCC, AML, Oncocytoma, lymphoma, non-neplastic masses (infection, AVM), renal pseudotumors (hypertrophied column of bertin, persistent fetal lobation
Types of RCC (5)
Clear cell, Papillary, chromophobe, collecting duct carcinoma, medullary carcinoma
Ddx; T2 hypointense lesion in kidney (3)
Lipid poor AML, hemorrhagic cyst, papillary RCC
Neoplastic differential of a cystic renal mass (3)
Cystic RCC. Multilocular cystic nephroma (enhancing septa. Baby boys and middle age women). Mixed epithelial stromal tumor (MEST); Middle aged women
Non-neoplastic differential for cystic renal mass
Renal abscess, Hemorrhagic renal cyst
Bosniak CT classification?
Category I: simple cyst. II: three of fewer septa, maybe small calcs. also includes small (<3cm) high density cyst w/o enhancement. IIF: may have thick and nodular mural calcifications. walls may slightly enhance. Also includes large (>3cm) hyperattenuating cysts w/o enhancement III: thick, irregular wall, enhancement. Class IV: Enhancing nodular component
DDx for unilateral enlarged kidney (4)
Pyelonephritis, acute ureteral obstruction, renal vein thrombosis, compensatory hypertophy.
DDx for striated nephrogram (7)
Pyelonephritis, renal infarct, renal veinthrombosis/vasculitis, renal contusion, acute urinary obstruction, renal tumor, radiation nephritis.
Ddx for papillary necrosis (postcard)
Pyelonephritis, obstruction, Sickle, TB, Cirrhosis, Analgesics (Nsaids), Renal vein thrombosis, Diabetes mellitus.
Ddx medullary nephrocalcinosis (5)
Hypercalcemic state (hyperparathyroidism, sarcoid), medullary sponge kidney, RTA 1, furosomide therapy in child. Papillary necrosis.
Ddx cortical nephrocalcinosis (5)
Acute cortical necrosis, hyperoxaluria, alport syndrome (hereditary nephropathy and deafness). Autosomal recessive PCKD. (also chronic glomerulonephritis and transplant rejection).
Ddx Echogenic renal mass
AML (shadowing is specific), RCC, calculus, gas, Milk of calcium, sloughed papilla.
Ddx extracalyceal contrat medium
Tubular ectasia, calyceal diverticulum, papillary necrosis.
Renal trauma grading
I; contusion, subcapsular hematoma. II; superficial laceration (<1cm), confined perinephric hematoma. III; Deeper laceration (>1cm) w/o extravasation. IV; deep lac extending to collecting system, or injury to renal artery/vein w/ contained hemorrhage. Needs surgeical repair. V; shattered kidney, avulsion of renal hilum.
Ddx Mag 3 - normal flow with abnormal renogram phase
ATN (if early after transplant), drug toxity (cyclosporin) (if later after transplant)
Ddx Mag 3 - abnormal flow and renogram phase
Acute rejection
Post-transplant fluid collections (4)
Hematoma (post-op), Urinoma; (1-2 weeks), will have tracer. Abscess (3-4 wks) Lymphocele; 4-8 weeks, no tracer.
Vascular complications following renal transplant (3)
Renal vein thrombosis (reversal of diastolic flow). RAS (parvus tardus). Pseudoaneurysm (usually due to biopsy)
Types of ureteroceles (3)
Orthoptic ureterocele (most commonly adults), ectopic ureterocele (children), pseudoureterocele (intussusception of distal ureter into bladder. May be due to radiation cystitis, or UVJ stone).
Cancers of urinary system
TCC (Most common), SCC (Schistosomiasis), Adenocarcinoma (urachal remnant)
Benign ureteral masses (3)
Fibroepithelial polyp, urothelial papilloma, inverted papilloma
Inflammatormy/infectious ureteral disease (4)
Ureteritis Cystica, Leukoplakia (Squamous metaplasia), Malacoplakia, Ureteral TB.
Bladder injury classification (2)
extraperitoneal (2X more common), or intraperitoneal
Turner’s syndrome
Horseshoe kidney, streak ovaries, Bicuspid aortic valve, coarctation.
NF1
Lateral meningocele, Neurofibromas, optic gliomas, sphenoid wing dysplasia, RAS.
MEN-1 (PPP)
Pancreatic islet cell (Gastrinoma), pituitary adenoma, parathryoid adenoma.
MEN2A (MPP)
Medullary thyroid cancer, pheo, parathyroid adenoma
MEN2B (MPN)
Medullary thyroid. Pheo, neuromas
VHL association (3 letters = 3 categories). (3 in pancreas, 3 in other belly, 3 in CNS) + epidydimal cysts.
Serous Cystadenoma, regular cysts, islet cell tumors. Preo, RCC (younger age/clear cell), Renal cysts. Hemangioblastoma in brain, hemangiomioblastoma in spine, Endolymphatic sac tumor.
Tuberous sclerosis features. Type of mutation. Findings (3 categories)
Aut D. Tumor suppressor gene mutation. Seizures, developmental delay, mostly benign tumors. Renal cysts, AMLs, slight increase risk of RCC, Cerebral hamartomas. Cardiac rhabdomyomas(sarcomas). Skeletel osteomas. Pulmonary lymphangioleiomyomatosis.
Tuberous sclerosis tumor locations (3 kidney, 1 in brain, heart, bones, lungs)
Renal cysts, AMLs, slight increase risk of RCC, Cerebral hamartomas. Cardiac rhabdomyomas(sarcomas). Skeletel osteomas. Pulmonary lymphangioleiomyomatosis.
