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DD FRCR2A > GU > Flashcards

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1
Q

Retroperitoneum

A

Ant. Pararenal space - asc + desc colon, pancreas, 2nd and 3rd duod
Perirenal space- Kidneys, prox ureter, adrenals
Post. Pararenal space - only contains fat but can be involved with inflammation

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2
Q

Liposarcoma

A

Most common 1° retroperitoneal malignant tumour
Most commonly fat containing ( least aggressive)
More aggressive subtypes have minimal fat

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3
Q

Retroperitoneal fibrosis

A

Fibrosis deposition In the retroperitoneum leading to ureteric obstruction.
No displacement of aorta away from spine

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4
Q

Retroperiotneal haematoma

A

2° to ruptured AAA, trauma, renal AML or haemorrhagic cyst

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5
Q

Adrenal adenomas

A

Can cause cushings or conns syndrome.

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6
Q

Adrenal adenoma

A

Microscopic fat
Rapid wash-out characteristics on contrast enhanced CT
<10HU on non con is definite adenoma
>10 HU contrast given to assess characteristics

Adenoma has absolute washout >60% and relative washout >40%

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7
Q

Collsion tumour

A

Co-existence of two tumours within adrenal mass such as metastasis within adrenal adenoma or myelolipoma.

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8
Q

Absolute washout

A

Enhanced attenuation - delayed attenuation
/
Enhanced attenuation - unenhanced attenuation

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9
Q

Relative washout

A

Enhanced attenuation - delayed attenuation
/
Enhanced attenuation

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10
Q

Chemical shift imaging

A

Adenomas suppress on OOP images whilst metastases do not

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11
Q

Adrenal myelolipoma

A

Adrenal mass with macroscopic fat
Usually incidental and can be large (>4cm)

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12
Q

Pheochromocytoma

A

Neuroendocrine tumour of adrenals
Can be large and heterogenous due to central necrosis.
Avid enhancement on CT and ++T2 signal on MRI.
IO-123 and In-111 can be used to detect it.
Assoc. MEN 2, VHL,NF1,Carney’s triad .
If bladder is involved can cause post-micturition syncope .

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13
Q

Adrenal Mets

A

Lung and Melanoma are most common primaries.

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14
Q

Adrenal calcifications

A

Can be 2° to :
Previous haemorrhage
Granulomatosis with polyangitis
TB
Histoplasmosis

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15
Q

HIV nephropathy

A

Can cause bilateral enlarged and echogenic Kidneys

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16
Q

Unilateral delayed nephrogram (slow parenchymal uptake of contrast ) causes

A

Acute ureteral obstruction
Renal artery stenosis
Renal vein thrombosis
Acute pyelonephritis

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17
Q

Unilateral prolonged (hyperdense) nephrogram:

A

Acute ureteral obstruction
Renal artery stenosis
Renal vein thrombosis

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18
Q

Bilateral persistent nephrogram

A

Systemic hypotension
Acute tubular necrosis
Contrast or urate nephropathy
Myeloma (proteinuria)
Bilateral obstruction

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19
Q

Striated nephrogram causes

A

Acute obstruction
Pyelonephritis
Infarct
Acute tubular necrosis
Contusion
Hypotension
ARPKD
hypotension

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20
Q

Medullary nephrocalcinosis

A

Calcification of renal medullary pyramids secondary to hypercalcaemia or hypercalciuria

Preserved renal function
Causes :
Hyperparathyroidism
Sarcoid
Renal tubular acidosis
Medullary sponge kidney
Papillary necrosis

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21
Q

Cortical nephrocalcinosis

A

Dystrophic peripheral calcification of renal cortex with sparing of pyramids
Due to :
Cortical necrosis
Chronic glomerulonephritis
Transplant rejection
Alport syndrome (deaf too )
ARPKD.

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22
Q

Cortical necrosis

A

2° to hemolytic uraemic syndrome and thrombotic microangiopathy
Reduced renal cortex enhancement with preservation of medullary enhancement.

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23
Q

Papillary necrosis

A

Common causes:
NSAIDS, SCD,diabetes, renal vein thrombosis

US: focal echogenic papilla
CT: pooling of contrast in papillary regions adjacent to calyces. Can have filing defects in calyces, renal pelvis or ureter due to sloughed papilla

Ball on tee sign : contrast filling central papilla
Lobster claw: contrast filling periphery of papilla
Signet ring sign : contrast surrounding sloughed papilla

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24
Q

Renal artery pseudoaneurysm or AV fistula characteristics

A

Hyperattenuating focus with density similar to aorta
Decreases in attenuation on delayed phase

Active bleed will increase in attenuation or size with delayed phase imaging

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25
Page kidney
Cause of 2° hypertension due to extrinsic compression of kidney by haematoma after trauma . Takes several months to develop.
26
Which stones are not radioopaque on CT
Indinavir stones Matrix stones (mucin) Uric acid Xanthine Pure struvite
27
Soft tissue rim sign
Small amount of soft tissue surrounding calcification in ureter thought to represent oedematous ureteral wall. (Not seen with phleboliths )
28
Obstruction without hydronephrosis
Very acute obstruction Severe dehydration Obstruction with ruptured fornix
29
Recently passed stone
Hydronephrosis without obstruction
30
Focal pyelonephritis
Can mimic renal mass Hypoechoic mass or masses that disrupts corticomedullary junction. Lacks distinct wall. Can have associated mild hydronephrosis.
31
Emphysematous pyelonephritis
Renal parenchyma replaced by gas Usually 2° to E Coli Needs broad spectrum abx and likely nephrectomy.
32
Renal TB
Focal cavitary lesion with calcification Also scarring , papillary necrosis and infundibular strictures End-stage : Putty kidney (atrophic and calcified) or autonephrectomy.
33
XGP pyelonephritis
Chronic infection 2° to Staghorn calc Renal parenchyma replaced with fibrofatty inflammatory tissue (Localised form is called tumefactive XGP and can mimic renal mass ) **Bear paw sign** of fibrofatty masses. Complications- perinephric abscess and fistula formation
34
HIV Nephropathy
Focal segmental glomerulosclerosis **Echogenic and Enlarged ** Kidneys Renal failure
35
ADPKD
Bilateral enlarged Kidneys with multiple large cysts 70% have multiple hepatic cysts 15% have saccular cerebral aneurysms
36
ARPKD
Bilateral enlarged kidney with **tiny** renal cysts. Hepatic fibrosis usually develops Presents in utero as enlarged echogenic Kidneys
37
Acquired cystic kidney disease
Pts on long term dialysis Small renal cysts in atrophic Kidneys Increased risk of renal cell ca
38
Lithium nephropathy
Can present as nephrogenic diabetes insipidus or chronic renal insufficiency Scattered microcysts in bilateral normal sized Kidneys
39
Solid renal masses
>3cm , 75% are malignant Assess renal veins for tumour thrombus and extension
40
RCC
Rf: Smoking VHL Tuberous sclerosis on US is isoechoic to renal cortex Tumor thrombus has colour doppler with arterial wave form
41
Clear cell RCC
Most common type Enhances most on CT and MR T2 hyperintense
42
Papillary RCC
Hypovascular subtype Only mildly enhances T2 hypointense with mild enhancement
43
Renal medullary ca
Aggressive Ill defined , infiltrative , hypovascular central mass with necrosis being common . Affects males with sickle cell trait
44
Renal lymphoma
Multiple hypoechoic renal masses Little enhancement
45
Treated ca cervix
T2 Hypointense
46
Myometrium ca
Normal uterus high t2 endometrium , dark junctionanl zone , isointense myometrium. Avidly enhances Tumour enhances less than myometrium
47
Dwi in endometrial ca
Dwi is good sequence for drop Mets. Restricts
48
Pre eclampsia and cortical blindness
PRES
49
Ovarian thecoma
Unilateral solid ovarian mass Increased endometrial thickness Multicystic
50
Ovarian hyperstimulatioj syndrome
Small pleural Effusion Fever Nausea Ascites Bilateral small ovarian cystic lesions
51
Intraductal lesion
Most common is papilloma
52
Brca2
Annual mri up to 40 and then mri +mammo after that
53
Tp53 and ataxia telagiectasia breast
Mri only
54
Abnormal tfts and increased uptake
GRAVES
55
Prostate
Dwi for peripheral High T2 for transitional
56
Gartner cyst
Anterior upper vagina
57
Bartholin cyst
Posterior / near anus
58
Skene gland
Anterior to vagina , below perineal membrane
59
Solid lesion post vasectomy
Sperm granuloma
60
Testes cancer
Para-aortic is local/ regional spread
61
Goblet sign in ureter
TCC and endometriosis
62
Renal pelvis mass
TCC
63
Cadasil
Temporal lobe and external capsule high T2
64
Lewy body
Spares cingulate gyrus

DD FRCR2A (6 decks)

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