1. kidney, \ 7cm 3. inside gerota's fascia a. renal vein b. ivc below diaphragm c. ivc above diaphram 4. beyond gerota's, adrenal

GU Flashcards by Amanda Crawford

“Molar tooth” extrav from the bladder

extraperitoneal

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Name a syndrome with increased risk of RCC.

VHL

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How is prostate cancer staged?

Not detectable on imaging.
Confine to the prostate
Extends outside capusle and may involve seminal vesicals.
Invasion of rectum, levator, or pelvic wall

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Solid adnexal mass + abnormal endometrium

endometrial hyperplasia 2/2 granulosa cell tumor

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egg shell like calcs in the bladder wall?

Schistosomiasis infxn

(developing countries middle east and africa)

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

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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MC epidydimal tumor?

Adenomatoid tumor

-30% of extratesticular masses

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Struma ovarii

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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Potter sequence

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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Mayer-Rokitansky-Kuster-Hauser

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

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What are some risks associated with Horseshoe kidney?

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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Which kidney is inferior in crossed fused renal ectopia?

ectopic

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calcs in a fatty renal mass

always RCC

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enhancing renal mass

always RCC

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RCC bony mets- lytic or blastic?

always lytic

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Most common subtype RCC?

clear cell.

assoc w/ VHL

more aggro than papillary

enhances equal to cortex

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

Papillary RCC

2nd most common RCC subtype

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RCC Subtype assoc with Sickle Cell Trait

Medullary

aggro

large

happens in younger patients

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RCC subtype associ with Birt Hogg Dube

Chromophobe

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Birt Hogg Dube

lung cysts (w/ spont ptx)

mult bilat renal tumors (including oncocytomas)

cutaneous stuff

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RCC Staging

kidney, <7cm
kidney, >7cm
inside gerota’s fascia
a. renal vein
b. ivc below diaphragm
c. ivc above diaphram
beyond gerota’s, adrenal

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Renal lesion associated with tuburous sclerosis

AML

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

oncocytoma

could show spoke wheel vascular pattern on u/s

hot on PET

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

Multilocular cystic nephroma zzz: protrudes into the renal pelivs 4 yo boys and 40yo women

homogenous renal lesion with greater than 70 HU

benign proteinaceous or hemorrhagic hyperdense cyst

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

ADPKD

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

ARPKD

increased risk of malignancy with dialysis?

3-6x

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

VHL Auto Dominant

panc serous microcystic adenomas, islet cell tumor pheo, multiple hemangioblastomas of cerebellum, brain stem and spinal chord

VHL

hamartoma party with renal AMLs +LAM in chest Rhabdomyosarc in heart giant cell astrocytoma in brain

tuberous sclerosis

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

lithium nephropathy

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

Multicystic dysplastic kidney

Difference between peri and para pelvic cysts?

Peri orifinates from renal sinus, mimics hydro Para originates from parenchyma, compresses collecting system. Par**_a_** and Parenchym**_a_**

staghorn calc, psoas abscess, bear paw on CT

xanthogranulomatous pyelonephritis

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

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

shrunken clacificed kidney

TB. MC extrapulmonary site of infxn

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

HIV nephropathy

most common composition of renal stone

calcium oxalate

renal calc that can't be seen on CT

idinavir (HIV rx)

patient with history of shok develops thin renal calcs

cortical nephrocalcinosis

hyperechoic renal papilla/pyramids

_Medullary nephrocalcinosis_ hyperPTH or medullary sponge kidney lasix in a kid renal tubular acidosis (type 1)

Congenital cause of medullary nephrocalcinosis.

Medullary sponge kidney. THis is related to Ehler Danlos, Carolis, and Beckwith-Weidman

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

urinoma short term, lymphocele longer out

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

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

transplant RAS criteria

PSV \>200-300cm/sec PSC ration \>3.0 (external iliac artery/RA) Tarus parvus at hilum

reversal fo diastolic renal artery flow =?

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

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

PTLD

which immunosuppressant is associated with increased risk of urothelial cancer?

cyclophosphamide

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

Congenital (primary) megaureter

Weigert meyer rule

in a duplicated system, the upper pole moiety inserts inferior and medial upper pole prone to ereterocele and obstruction lower pole prone to reflux

difference between psuedoureterocele and ureterocele?

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

ectopic ureter

ureter inserts distal to external sphincter women incontinence

Congenital UPJ obstruction

MC congen GU anomaly bilat 20% of the time look for crossing vessels assoc with mcdk on other side

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

Turner's syndrome (XO)

salpingitis isthmica nodosa

nodular scarring of the faloopian tubes likely post-inflamm/infxn

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

Uterine AVM can kill you

non filling of uterus on HSG or multiple irregular linear filling defects T2 dark bands on MRI infertility

Ashermans Intrauterine adhesions

Hyaline degeneration of fibroid

MC fibroid outgrows blood supply do not enhance T2 dark

Carneous/Red fibroid degeneration

occurs during pregnancy 2/2 venous thrombosis peripheral rim of T1 high signal

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

adenomyosis will have T2 bright cystic changes too

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

30-50x

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

8 mm

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

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

"t-shaped uterus"

DES- drug thought to prevent miscarraige back in the day Zebra cancer: clear cell adenocarcinoma

vaginal tumor in a child

vaginal rhabdomyosarc

skene glad cysts

periurethral, can cause recurrent UTIs and urethral obstruction ÐIt would probably hurt to have one of these "skiing"

theca lutein cyst

multilocular cystic looking ovary (spoke wheel) - multifetal preg - moles - ovarian hyperstimulation syndrom

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

ovarian hyperstimulation syndrome

maximal ovarian volume in a post-menopausal woman

6mL

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

endometrioma

What are risky things with endometriomas-\> malignancy?

older than 45 bigger than 6-9cm enhancing mural nodule blood flow (unless pregnancy- then its "decidualized" and will get f/u

MRI of endometrioma looks...?

T1 bright (blood) No fat T2 dark (iron)

pelvic lesion female: "fishnet appearance" lacy enhanced through transmission disappears after 1-2 menstrual cycles

henorrhagic cyst

MC ovarian neoplasm younger than 20

dermoid

cystic ovarian mass with hyperechoid solid mural nodule fat sats

dermoid

ureteral wall calcifications (2 things)

TB schistosomiasis

medial deviation of the ureters

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)

Difference between serous ovarian and mucinous ovarian carcinoma?

**Serous** unilocular, papillary projections **mucinous** multi-locular, pseudomyxoma peritonei and scalloping

Differential for a BFM in an adult

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

What is Meigs syndrome?

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

black garland sign?

dark T1 and T2 signaal with ovarian fibromatosis B9

Brenner tumor

epithelial tumor of the ovary women in 50-70s fibrous calcs common

struma ovarii

subtype of ovarian teratoma- contains thyroid tissue possible question would be related to hyperthyroid or thyroid storm

what defines stage 3 prostate cancer?

bulging or frank extension through the capsule

MC testicular tumor?

Seminoma best prognosis- radiosensitive age usually 25 homogenous hypoechoic round mass T2 dark (in contrast to non-seminomatous GCTs which are higher)