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DD FRCR2A > GU > Flashcards

GU Flashcards

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
Q

Page kidney

A

Cause of 2° hypertension due to extrinsic compression of kidney by haematoma after trauma . Takes several months to develop.

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26
Q

Which stones are not radioopaque on CT

A

Indinavir stones
Matrix stones (mucin)
Uric acid
Xanthine
Pure struvite

27
Q

Soft tissue rim sign

A

Small amount of soft tissue surrounding calcification in ureter thought to represent oedematous ureteral wall. (Not seen with phleboliths )

28
Q

Obstruction without hydronephrosis

A

Very acute obstruction
Severe dehydration
Obstruction with ruptured fornix

29
Q

Recently passed stone

A

Hydronephrosis without obstruction

30
Q

Focal pyelonephritis

A

Can mimic renal mass
Hypoechoic mass or masses that disrupts corticomedullary junction.
Lacks distinct wall.
Can have associated mild hydronephrosis.

31
Q

Emphysematous pyelonephritis

A

Renal parenchyma replaced by gas
Usually 2° to E Coli
Needs broad spectrum abx and likely nephrectomy.

32
Q

Renal TB

A

Focal cavitary lesion with calcification
Also scarring , papillary necrosis and infundibular strictures
End-stage : Putty kidney (atrophic and calcified) or autonephrectomy.

33
Q

XGP pyelonephritis

A

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
Q

HIV Nephropathy

A

Focal segmental glomerulosclerosis
**Echogenic and Enlarged ** Kidneys
Renal failure

35
Q

ADPKD

A

Bilateral enlarged Kidneys with multiple large cysts
70% have multiple hepatic cysts
15% have saccular cerebral aneurysms

36
Q

ARPKD

A

Bilateral enlarged kidney with tiny renal cysts.
Hepatic fibrosis usually develops

Presents in utero as enlarged echogenic Kidneys

37
Q

Acquired cystic kidney disease

A

Pts on long term dialysis
Small renal cysts in atrophic Kidneys
Increased risk of renal cell ca

38
Q

Lithium nephropathy

A

Can present as nephrogenic diabetes insipidus or chronic renal insufficiency
Scattered microcysts in bilateral normal sized Kidneys

39
Q

Solid renal masses

A

> 3cm , 75% are malignant
Assess renal veins for tumour thrombus and extension

40
Q

RCC

A

Rf:
Smoking
VHL
Tuberous sclerosis

on US is isoechoic to renal cortex
Tumor thrombus has colour doppler with arterial wave form

41
Q

Clear cell RCC

A

Most common type
Enhances most on CT and MR
T2 hyperintense

42
Q

Papillary RCC

A

Hypovascular subtype
Only mildly enhances
T2 hypointense with mild enhancement

43
Q

Renal medullary ca

A

Aggressive
Ill defined , infiltrative , hypovascular central mass with necrosis being common .
Affects males with sickle cell trait

44
Q

Renal lymphoma

A

Multiple hypoechoic renal masses
Little enhancement

45
Q

Treated ca cervix

A

T2 Hypointense

46
Q

Myometrium ca

A

Normal uterus high t2 endometrium , dark junctionanl zone , isointense myometrium. Avidly enhances

Tumour enhances less than myometrium

47
Q

Dwi in endometrial ca

A

Dwi is good sequence for drop Mets. Restricts

48
Q

Pre eclampsia and cortical blindness

A

PRES

49
Q

Ovarian thecoma

A

Unilateral solid ovarian mass
Increased endometrial thickness
Multicystic

50
Q

Ovarian hyperstimulatioj syndrome

A

Small pleural Effusion
Fever
Nausea
Ascites
Bilateral small ovarian cystic lesions

51
Q

Intraductal lesion

A

Most common is papilloma

52
Q

Brca2

A

Annual mri up to 40 and then mri +mammo after that

53
Q

Tp53 and ataxia telagiectasia breast

A

Mri only

54
Q

Abnormal tfts and increased uptake

A

GRAVES

55
Q

Prostate

A

Dwi for peripheral
High T2 for transitional

56
Q

Gartner cyst

A

Anterior upper vagina

57
Q

Bartholin cyst

A

Posterior / near anus

58
Q

Skene gland

A

Anterior to vagina , below perineal membrane

59
Q

Solid lesion post vasectomy

A

Sperm granuloma

60
Q

Testes cancer

A

Para-aortic is local/ regional spread

61
Q

Goblet sign in ureter

A

TCC and endometriosis

62
Q

Renal pelvis mass

A

TCC

63
Q

Cadasil

A

Temporal lobe and external capsule high T2

64
Q

Lewy body

A

Spares cingulate gyrus

DD FRCR2A (6 decks)

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