GU Flashcards
retroperitoneum –> soft tissue mass –> surround aorta/IVC –> retroperitoneal fibrosis vs malig LAD –> how differentiate?
retroperitoneal fibrosis –> rarely displace aorta away from spine
retroperitoneal hemorrhage –> CT –> w vs w/o IV contrast –> pros?
- w/o –> rapidly image pt
- w –> may detect actie extrav
pheochromocytoma/paraganglioma –> assoc synd? (5)
- mult endocrine neoplasia (MEN) 2A & B
- von Hippel-Lindau
extra-adrenal paraganglioma –> MC location?
organ of Zuckerkandl –> along aortic bifurcation to level of bladder
post-micturition syncope –> ddx? (1)
extra-adrenal paraganglioma involving bladder
extra-adrenal pheochromocytoma/paraganglioma –> potential NM studies? (3)
- Iodine-123 MIBG
- Indium-111 pentetreotide scintigraphy
- Gallium-68 DOTATATE PET/CT
what are glomus tumors?
paraganglioma of head/neck
glomus tumor (paraganglioma of head/neck) –> involving… is called…?
- tympanic membrane
- jugular foramen
- carotid body
- vagus N
- glomus tympanicum
- glomus jugulare
- carotid body tumor
- glomus vagale
pheochromocytoma –> MRI sign?
“light bulb” sign –> marked T2 hyper
adrenal gland –> masses arising from adrenal medulla? (4)
- pheochromocytoma
- neuroblastic tumors: ganglioneuroma, ganglioneuroblastoma, neuroblastoma
absent nephrogram –> ddx? (3)
- acute renal A/V occlusion
- chronic ureteral obstruct
- congenital/acquired renal dz –> nonfxing nephrons
what is bilat persistent nephrogram? ddx? (5)
both kidneys –> retain contrast >3min –> delayed urine excrete:
- systemic hypotension
- acute tubular necrosis
- bilat obstructive uropathy
- contrast nephropathy
- proteinuria –> ie. myeloma kidney
unilat delayed nephrogram –> ddx? (4)
- acute ureteral obstruct
- renal A stenosis
- renal V thrombosis/compression
- acute pyelonephritis
unilat prolonged (hyperdense) nephrogram –> ddx? (3)
- acute ureter obstruct
- renal A stenosis
- renal V thrombosis/compression
unilat striated nephrogram –> ddx? (6)
- acute urinary obstruct
- acute pyelonephritis
- renal infarct
- renal V thrombosis/vasculitis
- renal contusion
- acute rad tx
bilat striated nephrogram –> ddx? (5)
- acute urinary obstruct
- acute pyelonephritis
- acute tubular necrosis
- hypotension
- autosomal recessive polycystic kidney dz (ARPKD)
kidney –> excretory phase –> extra-calyceal contrast –> ddx? (3)
- tubular ectasia/medullary sponge kidney
- calyceal diverticulum
- papillary necrosis
what is medullary sponge kidney
tubular ectasia w assoc calcs of renal medullary pyramids
unilat enlrg kidney –> ddx? (4)
- pyelonephritis
- acute ureteral obstruct
- renal V thrombosis
- compensatory hypertrophy
what is Weigert-Meyer rule?
duplicated collecting system:
- upper pole ureter –> ectopic insert (med/inf) –> ureterocele, obstruct (upper obstructs)
- lower pole –> normal insert (lat/sup) –> reflux (lower refluxes)
medullary nephrocalcinosis –> causes? (6) MCC?
- # 1 hyperPTH
- renal tubular acidosis type 1
- medullary sponge kidney
- papillary necrosis
- child –> furosemide/lasix tx
cortical nephrocalcinosis –> causes? (6)
- acute cortical necrosis
- chronic glomerulonephritis
- chronic transplant reject
- hyperoxaluria
- Alport synd
- autosomal recessive polycystic kidney dz (ARPKD)
kidney –> cortical necrosis –> MOA?
small vessel vasospasm or systemic hypotension –> acute ischemia
kidney –> cortical necrosis –> CT appearance?
- renal cortex –> no enhance
- renal medulla –> normal enhance
what is papillary necrosis?
renal papillary tissue –> necrosis & slough
papillary necrosis –> clinical presentation?
gross hematuria
papillary necrosis –> potential comp?
chronic renal insuff
papillary necrosis –> MC causes? (4)
- NSAIDs
- sickle cell
- DM
- renal V thrombosis
papillary necrosis –> 3 classic signs?
- “ball on tee”
- “lobster claw”
- “signet ring”
what is page kidney?
subcapsular collection (ie hematoma, urinoma) –> compress kidney –> 2ary HTN
hydronephrosis –> nonobstructive cause? (2)
- vesicoureteral reflux
- preg
what is xanthogranulomatous pyelonephritis?
obstructing staghorn calculus –> chronic renal infx –> fibrofatty inflamm tissue –> replace renal parenchyma
xanthogranulomatous pyelonephritis –> 2 MC org?
- proteus
- Ecoli
HIV nephropathy –> specific US findings?
enlrg echogenic kidneys
lithium nephropathy –> classic CT appearance?
bilat kidney –> normal size –> numerous scattered uniform microcysts
RCC –> subtypes? (3) MC type?
- # 1 clear cell
- papillary
- chromophobe
renal medullary CA –> MC epidemiology?
sickle cell
renal lesion –> macroscopic fat & calc –> ddx?
RCC w macroscopic fat
renal mass –> looks like RCC –> another ddx? (1)
oncocytoma
von Hippel-Lindau (VHL) –> manifestations? (6)
- renal cysts –> mult bilat RCC –> clear cell subtype
- multifocal pheochromocytoma
- CNS hemangioblastoma
- pancreatic neuroendocrine tumor
- pancreas serous cystadenoma
- pancreas/liver cysts
Birt-Hogg-Dube –> manifestations? (4)
- derm lesions
- cystic lung dz
- mult renal oncocytomas
- RCC –> chromophobe subtype
mult bilat renal angiomyolipomas –> ddx? (1)
tuberous sclerosis
renal transplant –> comp –> fluid collection –> ddx based on timing?
- immed postop
- 1-2wk postop
- 3-4wk
- > 2mo
- immed postop: hematoma
- 1-2wk postop: urinoma
- 3-4wk: abscess
- > 2mo: lymphocele
what is ureteritis cystica?
ie. chronic infx, stone dz –> chronic urinary tract inflamm –> several small subepithelial cysts –> benign –> mult tiny filling defects
ureter –> what is leukoplakia (squamous metaplasia)?
rare urothelial inflamm condition –> white patch
ureter –> leukoplakia (squamous metaplasia) –> charact appearance?
“corduroy” appearance
what is malacoplakia?
rare –> chronic UTI –> chronic inflamm granulomatous condition
malacoplakia –> epidemiology?
mid age F
malacoplakia –> imaging appearance?
bladder and/or distal ureter –> mult flat filling defects
multifocal ureteral stenosis –> ddx?
TB
kidney TB –> imaging appearance?
parenchymal calc & scarrin
bladder TB –> imaging appearance?
small capacity bladder –> thick wall
prostate CA –> MRI findings?
- DWI
- T2
- enhance
- restrict diff
- T2 low
- early enhance (compared to surrounding peripheral zone)
prostate CA –> what is hemorrhage exclusion sign?
post-bx:
- normal prostate tissue –> high [citrate] –> more bleed –> T1 hyper
- neoplastic tissue –> lower [citrate] –> bleed less –> T1 low
prostate CA –> peripheral vs transitional zone lesion –> which MRI seq is used to assign PI-RADS category?
- peripheral –> ADC
- transitional –> T2
adrenal mass –> portal venous HU >120 –> rapid washout –> ddx? (2)
NOT an adenoma!
- met
- pheo
Conn synd (synd of excess aldosterone) –> MCC?
benign adenoma
MEN synd (3)?
MEN1 (3P):
- pituitary
- parathyroid
- pancreas
MEN2A (2P 1M):
- parathyroid
- pheo
- medullary thyroid
MEN2B (1P 2M):
- pheo
- medullary thyroid
- marfanoid habitus / mucosal neuroma
