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GU Flashcards

1
Q

name 2 nuclear tests performed for f/u reflux:

A

RCN

DMSA

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2
Q

What is the Weigert–Meyer rule re duplex PC system

A

there is an increased risk of obstruction (in the upper pole moiety) and reflux (in the lower pole moiety)

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3
Q

Where does the upper pole insert?

A

the upper pole ureter inserts ectopically (inferomedially) into the bladder and is prone to obstruction,

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4
Q

Where does the lower pole insert?

A

The lower pole ureter inserts orthotopically (normally) but is prone to reflux.

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5
Q

Ddx of Drooping lily sign on VCUG

A
  1. Renal ptosis, which would be expected to show a normal number of calyces.
  2. obstructed upper pole of the drooping lily has fewer calyces.

Seen in some patients with a duplicated collecting system. It refers to the inferolateral displacement of the opacified lower pole moiety due to an obstructed (and unopacified) upper pole moiety.

The similarity to a lily is further strengthened by the small number of calyces the lower pole moiety has

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6
Q

Tx for PUJ obstruction

A

Pyeloplasty

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7
Q

How to differentiate bwn PUJ obstruction and prominent extra renal pelvis

A

Whitaker test - Urodynamic study with integrate pyelogram

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8
Q

Abrupt calibre change bwn dilated posterior urethra and normal calibre anterior urethra on VCUG

A

Posterior urethral valves

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9
Q

MRI shows hydro in the kidney and a key hole in the bladder

A

Posterior urethral valves

Most Common cause of hydronephrosis in fetus is PUJ Obstruction

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10
Q

BUZZWORD: Perirenal fluid collection

A

Posterior urethral valves

Non specific, can b seen in obstructive picture.

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11
Q

main differential for posterior urethral valve

A

prune belly syndrome, which would show dilation of the ENTIRE ureter rather than only the prostatic portion

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12
Q

Prune belly triad:

A
  1. Crappy abdominal musculature. 2. Hydroureteronephrosis 3. Cryptorchidism- bladder distention interferes with descent of testes
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13
Q

What is the diagnosis?

focal dilation of the distal ureter within the bladder wall, where the ureter infolds between the mucosal and muscular layers of the bladder wall.

A

Ureterocele

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14
Q

Cobra head sign: contrast surrounded by a lucent rim protruding from the contrast filled bladder

A

Ureterocoele

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15
Q

The ureterocoele is associated with….

A

Duplicated system- specially the upper pole

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16
Q

MCDK

A
  1. No functioning renal tissue
  2. Contralateral renal tract abnormalities 50% of the time
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17
Q

TS (4)

A
  1. Renal cysts
  2. Renal angiomyolipomas.
  3. Cardiac rhabdomyoma.
  4. CNS cortical hamartomas, subependymal nodules, and subependymal giant cell astrocytoma.
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18
Q

VHL (5)

A
  1. Renal cysts
  2. Renal cell carcinoma (RCC): Up to 30% of VHL patients die from RCC.
  3. Adrenal pheochromocytoma.
  4. Pancreatic cysts, islet cell tumors, and serous cystadenomas.
  5. Brain and spinal cord hemangioblastomas.
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19
Q

BUZZWORD: Protrudes into renal pelvis

A

Multilocular cystic nephroma

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20
Q

What is the diagnosis?

Bilateral enlarged and diffusely echogenic kidneys with loss of CM differentiation- No urine in the bladder in utero

A

ARPKD

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21
Q

Liver findings in ARPKD

A

Abnormal bile ducts and fibrosis.

22
Q

RF for Wilm’s tumour (4)

A
  1. Beckwith–Wiedemann syndrome (hemihypertrophy, macroglossia, omphalocele, neonatal hypoglycemia (due to insulin overproduction by pancreatic β-cells), and increased risk of childhood malignancies, including Wilms tumor and hepatoblastoma).
  2. WAGR syndrome (Wilms tumor, aniridia, genitourinary anomalies, and mental retardation).
  3. Horseshoe kidney: Approximately 2x incidence of Wilms tumor.
  4. Trisomy 18.
23
Q

What is the diagnosis?

heterogeneous, solid renal mass. The claw sign indicates renal parenchyma origin. Tumor venous extension is seen in 5–10%.

Calcifications may be present.

A

Wilm’s tumour

24
Q

Ddx multilocular cystic nephroma.

A

cystic Wilm’s tumour

25
Q

Bilateral Wilm’s tumour

A

They had nephroblastomatosus in 99%

26
Q

Hypodense rind , homogenous mass, with no necrosis

A

Nephroblastomatosis

27
Q

Beckwith Weidemann

A

Wilms

Omphalocele

Hepatoblastoma

28
Q

What is the diagnosis?

Wilms

Omphalocele

Hepatoblastoma

A

Beckwith Weidemann

29
Q

Primary malignancies with potential metastases to kidneys(3)

A
  1. Neuroblastoma
  2. Leukaemia
  3. Lymphoma
30
Q

Similar to Wilm’s tumour in younger children < 1 year old

A

Mesoblastic nephroma

31
Q

Multiple AMLs are associated with….

A

TS

32
Q

What is the lesion?

suprarenal mass, with calcifications seen in ~50%.

A

adrenal neuroblastoma

33
Q

Neuroblastoma vs Wilm’s tumour

A

Neuroblastoma tends to encase vessels, while Wilms tumor is known to displace vessels.

34
Q

MRI findings of neuroblastoma

A

On MRI, neuroblastoma often:

  1. invades into neural foramina and the spinal canal.
  2. Diffusion is often restricted, reflecting hypercellularity.
35
Q

NM test for adrenal neuroblastoma

A

I-123 MIBG scintigraphy

same test used for phaeo, carcinoid

36
Q

A classic presentation of metastatic neuroblastoma

A

intracranial, subdural mass originating from the marrow

37
Q

Neuroblastoma vs ganglioneuroma

A
  1. In contrast to neuroblastoma, ganglioneuroma affects slightly older children (most common age of a ganglioneuroma patient is 6 years old)
  2. only 50% of ganglioneuromas are positive on I-123 MIBG scintigraphy.
  3. MRI classically shows restricted diffusion of a neuroblastoma, but not in ganglioneuroma.
38
Q

What is the lesion?

ultrasound: a hypoechoic, avascular, suprarenal mass. Hemorrhage may appear similar to neuroblastoma on initial ultrasound, but a follow-up scan would demonstrate involution.

A

Adrenal haemorrhage

39
Q

Name 2 conditions associated with adrenal cortical carcinoma

A
  1. Beckwith–Wiedemann and
  2. Li–Fraumeni syndromes
40
Q

Risk of which type of cancer with urachus remnant?

A

Adenocarcinoma

41
Q

What is the lesion?

Imaging features a characteristic lobulated, bunch of grapes appearance.

A

Rhabdomyosarcoma

42
Q

What is the lesion?

…….. is usually apparent on prenatal imaging. When detected after birth the characteristic clinical appearance is a skin-covered mass extending from the midline buttocks. It has a heterogeneous imaging appearance with cystic, solid, and fatty components.

A

Sacrococcygeal teratoma

43
Q

Horseshoe kidneys increase the risk of which malignancies?

A
  1. TCC
  2. Wilm’s
  3. Renal carcinoid
44
Q

Renal artery thrombosis

secondary to ….

What does is cause?

A

secondary to umbilical artery catheter.

Does not cause enlargement but causes severe HTN.

45
Q

renal masses in neonates

A
  1. Nephroblastomatosis
  2. Mesoblastic nephroma- hamartoma (polyhydramnios)§
46
Q

patients is too young to have wilms tumour, what is the diagnosis?

A

Mesoblastic nephroma

47
Q

bilateral wilms

A

Nephroblastomatosis

48
Q

I say Beckwith Weidemann, you say….

A
  1. Wilms
  2. Omphalocele
  3. Hepatoblastoma
49
Q

paratesticular mass with lung and bone metastases

A

rhabdomyosarcoma

50
Q

AFP is usually elevated in this testicular tumour

A

Yolk sac tumour (non seminoma)

Paeds (6 decks)

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