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GU Flashcards

1
Q

“Molar tooth” extrav from the bladder

A

extraperitoneal

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2
Q

Name a syndrome with increased risk of RCC.

A

VHL

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3
Q

How is prostate cancer staged?

A
  1. Not detectable on imaging.
  2. Confine to the prostate
  3. Extends outside capusle and may involve seminal vesicals.
  4. Invasion of rectum, levator, or pelvic wall
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4
Q
A
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5
Q

Solid adnexal mass + abnormal endometrium

A

endometrial hyperplasia 2/2 granulosa cell tumor

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6
Q

egg shell like calcs in the bladder wall?

A

Schistosomiasis infxn

(developing countries middle east and africa)

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7
Q

How to remember the difference between Bartholin and Gartner duct cysts?

A

One doesn’t let Bart in (Bartholin) because it is at the posterior introitus.

The other is Gartner. Garden along the front and sides of the house.

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8
Q

MC epidydimal tumor?

A

Adenomatoid tumor

-30% of extratesticular masses

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9
Q

Struma ovarii

A

mature cystic teratoma composed entirely or predominantly of thyroid tissue. The presence of fat in an ovarian lesion does not preclude the diagnosis of struma ovarii.

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10
Q

Potter sequence

A

if kidneys don’t form, yhou don’t make pee

if you don’t make pee, you don’t develop lungs

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11
Q

Mayer-Rokitansky-Kuster-Hauser

A

unilateral renal agenesis with mullerian duct anomalies including absence/atresia of the uterus

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12
Q

What are some risks associated with Horseshoe kidney?

A

IMA gets hung up

8x increased risk of Wilm’s Tumor

TCC (from more frequent infections)

Rare: renal carcinoid

Turner’s syndrome more likely to have horesehoe

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13
Q

Which kidney is inferior in crossed fused renal ectopia?

A

ectopic

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14
Q

calcs in a fatty renal mass

A

always RCC

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15
Q

enhancing renal mass

A

always RCC

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16
Q

RCC bony mets- lytic or blastic?

A

always lytic

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17
Q

Most common subtype RCC?

A

clear cell.

assoc w/ VHL

more aggro than papillary

enhances equal to cortex

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18
Q

Renal tumor that enhances less than cortex and is less aggro than clear cell

A

Papillary RCC

2nd most common RCC subtype

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19
Q

RCC Subtype assoc with Sickle Cell Trait

A

Medullary

aggro

large

happens in younger patients

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20
Q

RCC subtype associ with Birt Hogg Dube

A

Chromophobe

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21
Q

Birt Hogg Dube

A

lung cysts (w/ spont ptx)

mult bilat renal tumors (including oncocytomas)

cutaneous stuff

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22
Q

RCC Staging

A
  1. kidney, <7cm
  2. kidney, >7cm
  3. inside gerota’s fascia
    a. renal vein
    b. ivc below diaphragm
    c. ivc above diaphram
  4. beyond gerota’s, adrenal
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23
Q

Renal lesion associated with tuburous sclerosis

A

AML

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24
Q

bening renal tumor that looks like rcc, but has central scar?

A

oncocytoma

could show spoke wheel vascular pattern on u/s

hot on PET

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25
Q

renal lesion: non-communicating fluid-filled locules surrounded by thick fibrous capsule

A

Multilocular cystic nephroma

zzz: protrudes into the renal pelivs

4 yo boys and 40yo women

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26
Q

homogenous renal lesion with greater than 70 HU

A

benign proteinaceous or hemorrhagic hyperdense cyst

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27
Q

genetic renal disease with liver cysts, berry aneurysms, kidneys get larger and lose function, dialysis in 5th decade

A

ADPKD

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28
Q

genetic renal disease with HTN, associated biliary ductal abnormalities and fibrosis. kidneys are enlarged and diffusely echogenic with loss of corticomedullary differenctiation.

A

ARPKD

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29
Q

increased risk of malignancy with dialysis?

A

3-6x

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30
Q

25-50% of people with this disorder end up with RCC (clear cell)

A

VHL

Auto Dominant

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31
Q

panc serous microcystic adenomas, islet cell tumor

pheo, multiple

hemangioblastomas of cerebellum, brain stem and spinal chord

A

VHL

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32
Q

hamartoma party with renal AMLs

+LAM in chest

Rhabdomyosarc in heart

giant cell astrocytoma in brain

A

tuberous sclerosis

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33
Q

you are shown MRI of kidneys in patient with bipolar disorder with mult microcysts

A

lithium nephropathy

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34
Q

no functioning renal tissue and multiple small cysts in utero, contralateral renal tract abnormalities 50% of the time

A

Multicystic dysplastic kidney

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35
Q

Difference between peri and para pelvic cysts?

A

Peri orifinates from renal sinus, mimics hydro

Para originates from parenchyma, compresses collecting system.

Para and Parenchyma

36
Q

staghorn calc, psoas abscess, bear paw on CT

A

xanthogranulomatous pyelonephritis

37
Q

filling defect in renal calyx.. papillary necrosis. What causes it?

A

DM, peylo, sicke cell, TB, analgesics, cirrhosis

38
Q

shrunken clacificed kidney

A

TB. MC extrapulmonary site of infxn

39
Q

big kidney that is echogenis and renal sinus fat disappears (2/2 edema)

A

HIV nephropathy

40
Q

most common composition of renal stone

A

calcium oxalate

41
Q

renal calc that can’t be seen on CT

A

idinavir (HIV rx)

42
Q

patient with history of shok develops thin renal calcs

A

cortical nephrocalcinosis

43
Q

hyperechoic renal papilla/pyramids

A

Medullary nephrocalcinosis

hyperPTH or medullary sponge kidney

lasix in a kid

renal tubular acidosis (type 1)

44
Q

Congenital cause of medullary nephrocalcinosis.

A

Medullary sponge kidney.

THis is related to Ehler Danlos, Carolis, and Beckwith-Weidman

45
Q

Fluid collections that occus 2 weeks post op vs. 1-2 months post op from renal transplant

A

urinoma short term, lymphocele longer out

46
Q

How do you tell the difference between acute rejection and ATN?

A

best distinguished on MAG-3 where ATN has normal perfusion and rejection does not

Both will have delayed excretion

both occur about 1st week after surgery

47
Q

transplant RAS criteria

A

PSV >200-300cm/sec

PSC ration >3.0 (external iliac artery/RA)

Tarus parvus at hilum

48
Q

reversal fo diastolic renal artery flow =?

A

reval vein thrombosis. look for this in transplants. they won’t show the vein.

49
Q

cancer caused by immunosuppresion after transplant (usually at 1 year)

A

PTLD

50
Q

which immunosuppressant is associated with increased risk of urothelial cancer?

A

cyclophosphamide

51
Q

dilated ureter without obstuction, possibl from adynamic segment, UVJ reflux, or idiopathic

A

Congenital (primary) megaureter

52
Q

Weigert meyer rule

A

in a duplicated system, the upper pole moiety inserts inferior and medial

upper pole prone to ereterocele and obstruction

lower pole prone to reflux

53
Q

difference between psuedoureterocele and ureterocele?

A

pseudo is acquired possibly to impacted uereteral stone, recetly passed stone, or bladder malignancy

54
Q

ectopic ureter

A

ureter inserts distal to external sphincter

women

incontinence

55
Q

Congenital UPJ obstruction

A

MC congen GU anomaly

bilat 20% of the time

look for crossing vessels

assoc with mcdk on other side

56
Q

genetic prob with aortic co-arc, horseshoe kidney, and preburtal appearing uterus and streaky ovaries

A

Turner’s syndrome (XO)

57
Q

salpingitis isthmica nodosa

A

nodular scarring of the faloopian tubes

likely post-inflamm/infxn

58
Q

high velocity flow in serpiginous/tubular anechoic uterine structures in patient with previous D&C

A

Uterine AVM

can kill you

59
Q

non filling of uterus on HSG or multiple irregular linear filling defects

T2 dark bands on MRI

infertility

A

Ashermans

Intrauterine adhesions

60
Q

Hyaline degeneration of fibroid

A

MC

fibroid outgrows blood supply

do not enhance

T2 dark

61
Q

Carneous/Red fibroid degeneration

A

occurs during pregnancy

2/2 venous thrombosis

peripheral rim of T1 high signal

62
Q

thickening of the junctional zon of the uterus to >12mm

A

adenomyosis

will have T2 bright cystic changes too

63
Q

HNPCC

Hereditary Non-Polyposis Colon Cancer has what increased risk of endometrial cancer?

A

30-50x

64
Q

How thick can the endometrium get on Tamoxifin (SERM) without getting a bx?

A

8 mm

65
Q

When staging cervical cancer, which finding pushes you from surgery to chemo/radiation?

A

parametrial invasion or involvement of the lower 1/3 of the vagina bumps you up from IIA to IIB

Parametrium= fibrous band that separates the supravaginal cervix from the bladder… T2 dark ring around the cervic

66
Q

“t-shaped uterus”

A

DES- drug thought to prevent miscarraige back in the day

Zebra cancer: clear cell adenocarcinoma

67
Q

vaginal tumor in a child

A

vaginal rhabdomyosarc

68
Q

skene glad cysts

A

periurethral, can cause recurrent UTIs and urethral obstruction

ÐIt would probably hurt to have one of these “skiing”

69
Q

theca lutein cyst

A

multilocular cystic looking ovary (spoke wheel)

  • multifetal preg
  • moles
  • ovarian hyperstimulation syndrom
70
Q

theca lutein cysts, ascites, pleural effusions, +/- pericardial effusions

A

ovarian hyperstimulation syndrome

71
Q

maximal ovarian volume in a post-menopausal woman

A

6mL

72
Q

rounded mass with homogenous low level internal echoes and increased through transmission

(gyn)

A

endometrioma

73
Q

What are risky things with endometriomas-> malignancy?

A

older than 45

bigger than 6-9cm

enhancing mural nodule

blood flow (unless pregnancy- then its “decidualized” and will get f/u

74
Q

MRI of endometrioma looks…?

A

T1 bright (blood)

No fat

T2 dark (iron)

75
Q

pelvic lesion female:

“fishnet appearance”

lacy

enhanced through transmission

disappears after 1-2 menstrual cycles

A

henorrhagic cyst

76
Q

MC ovarian neoplasm younger than 20

A

dermoid

77
Q

cystic ovarian mass with hyperechoid solid mural nodule

fat sats

A

dermoid

78
Q

ureteral wall calcifications (2 things)

A

TB

schistosomiasis

79
Q

medial deviation of the ureters

A

retroperitoneal fibrosis (B)

retrocaval ureter (R)

pelvic lipomatosis

psoas hypertrophy (lower)

  • in contrast, if you see widening, think RP adenopathy, AAA, and psoas hypertrophy (proximal)
80
Q

Difference between serous ovarian and mucinous ovarian carcinoma?

A

Serous unilocular, papillary projections

mucinous multi-locular, pseudomyxoma peritonei and scalloping

81
Q

Differential for a BFM in an adult

A
  1. Ovarian masses- mucinous and serous
  2. desmoids- Gardener syndrome
  3. Sarcoma
82
Q

What is Meigs syndrome?

A

triad of ascites, pleural effusion, and benign ovarian tumor (MC fibroma)

83
Q

black garland sign?

A

dark T1 and T2 signaal with ovarian fibromatosis

B9

84
Q

Brenner tumor

A

epithelial tumor of the ovary

women in 50-70s

fibrous

calcs common

85
Q

struma ovarii

A

subtype of ovarian teratoma- contains thyroid tissue

possible question would be related to hyperthyroid or thyroid storm

86
Q

what defines stage 3 prostate cancer?

A

bulging or frank extension through the capsule

87
Q

MC testicular tumor?

A

Seminoma

best prognosis- radiosensitive

age usually 25

homogenous hypoechoic round mass

T2 dark (in contrast to non-seminomatous GCTs which are higher)

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