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Genitourinary > GU Diagnostics and Procedures > Flashcards

GU Diagnostics and Procedures Flashcards

1
Q

KUB stands for

A

Kidney, Ureter, Bladder (plain films)

-preliminary radiograph in extended radiologic examinations

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2
Q

Advantages / Disadvantages of KUB

A

A- Cost is low, x-ray is readily available at most facilities.

D- is the use of ionizing radiation and relatively poor soft- tissue contrast

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3
Q

Average size of adult kidney

A

12-14 cm (top to bottom)

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4
Q

what is Intravenous Pyelography (IVP)

A

plain film x-ray of abdomen initially; followed by more x-rays at timed intervals after IV injection of Iodine-containing contrast medium

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5
Q

What is a normal test with IVP

A

normal kidneys promptly excrete contrast agents

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6
Q

What is one thing that intravenous Pyelography (IVP) is very useful for

A

demonstrating small lesions in the urinary tract

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7
Q

Voiding Cystourethrography (VCUG) is utilized for

A

visualizing the urethra and urinary bladder during micturition.

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8
Q

How is VCUG conducted

A

Technique consists of catheterizing the person in order to fill the bladder with radiocontrast agent.

Under fluoroscopy or standard x rays, the radiologist watches the contrast enter the bladder and looks at the anatomy of the pt.

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9
Q

Name of the diagnosis for when contrast will move into the ureter and back to the kidneys during a VCUG

A

Vesicoureteral reflux

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10
Q

Indications of a VCUG

A
  • frequent UTI’s
  • suspected obstruction
  • Bladder trauma or post-op evaluation (examples prostatectomy, bladder repair)
  • Urinary stress incontinence
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11
Q

What is renal ultrasound commonly used for

A

the evaluation of the kidney, urinary bladder, prostate, testis, and penis.

ultrasound is useful for assessing renal size and growth and in detection and characterization of renal masses (solid vs cystic)

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12
Q

Advantages / Disadvantages of utilizing renal ultrasound

A

A- Ease of use, High pt tolerance, non invasiveness, lack of ionizing radiation, low relative cost, and wide availability

D- Tissue nonspecificity, limited field of view, and dependence on the operator’s skill and the pt’s habitus

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13
Q

What is the name of the test that measures the amount of urine left (residual) in the bladder after micturition

A

Post-Void Residual (PVR)

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14
Q

What are some of the disease processes that validate the need for post-void residual tests (PVR)

A

Neurogenic bladder
spinal cord injury, CVA, MS, Parkinson Dz

urinary outflow obstruction ie (BPH) .

previous pelvic surgery/trauma

medications - sedatives, opiates, calcium channel blockers

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15
Q

What is a big risk when PVR volumes are abnormal

A

High risks of UTI

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16
Q

what are the two methods to measure the amount of residual volume post micturition

which is safer

A

catheterization or or by using ultrasound (bladder scan)

Bladder scan is safer because it does not have risks of causing infection like the cath

however the use of Ultrasound is more expensive for the pt

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17
Q

what is an appropriate urine retention to be considered adequate bladder emptying

A

less than 50 cc

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18
Q

True or false - PVR of less than 100 is acceptable in pt’s that are over 65

A

True

19
Q

what volume remaining in the bladder is likely due to incomplete bladder emptying or

A

grater than 200 cc

20
Q

When is renal CT most commonly utilized

A

in the evaluation of acute flank pain, hematuria, renal infection (abscess), trauma, and in the characterization and staging of renal neoplasm/ masses

21
Q

mostly iodinated contrast media is used for renal CT’s

when is Contrast not utilized

A

in the evaluation for renal or perirenal calcification (stones), hemorrhage, or urine extravasation is suspected

22
Q

Advantages / Limitations of renal CT

A

A- wide field of view, ability to detect subtle differences of various tissue types, good spatial resolution, anatomical cross-sectional images, and relative operator independence

L- Include restriction to the transaxial plane when images obtained, low soft tissue contrast resolution, and the need for contrast media. Finally, radiation exposure is much higher than plain films

23
Q

No Contrast (CT)

A

renal stone study, pts who are in renal failure!!!, pts where renal function is i question need a referral for BUN/creatinine, within last 30 days

24
Q

Contrast is needed (CT) for

A

All abdominal work that emphasizes liver, pancreas, kidney, and or bladder

25
Q

Gold standard for the characterization of renal masses

A

CT of abd/pelvis

26
Q

Applications for use of Magnetic Resonance Angiography (MRA) in renal imaging

A

include demonstration of congenital anomalies, diagnosis of renal vein thrombosis, and diagnosis and staging of renal cell carcinoma.

27
Q

MR angiography is useful in

A

evaluating renal transplant vessels, renal vein tumor or thrombosis, and renal artery stenosis

28
Q

Advantages / Disadvantages of MRA in renal examination

A

A- direct imaging in any plane desired, choice of large or small field of view, excellent soft-tissue contrast, imaging without exposure to ionizing radiation. MRI can image blood vessels and the urinary tract without contrast material.

D- The scanning time is relatively slow and as a result image clarity is often inferior compared to CT. there are also higher costs associated

29
Q

indications for Renal Angiography

A

Suspected renal artery stenosis, vascular malformations, Tumor embolization to minimize surgical blood loss, Trauma

30
Q

Complications of renal angiography

A

include bleeding at puncture site, contrast allergy or nephrotoxicity, and renal emboli

31
Q

What is Cystoscopy

A

is a procedure were a thin, lighted cystoscopy is inserted into the bladder and urethra to better visualize the internal lining that is not seen by imaging.

32
Q

Indications for cystoscopy

A

Gold standard for diagnosing bladder cancer (can biopsy during procedure).

Evaluation of pat’s with voiding symptoms

gross or microscopic hematuria

Evaluation of urethral or bladder diverticula

congenital anomalies in pediatric pop.

intraop. evaluation after incontinence / prolapse procedures

Retrograde pyelography for upper urinary tract evaluation

bladder hydrodistention needs anesthesia in OP surgery setting

33
Q

Therapeutic indications of Cystoscopy

A

treatment of urethral strictures
bladder neck procedures
intravesical procedures
Reflux treatment in peds pop.

34
Q

Contraindications of Cystoscopy

A

febrile pt’s with UTI and those with severe coagulopathy

35
Q

Renal Biopsy indications

A

unexplained renal failure, acute nephritic syndrome, nephrotic syndrome, isolated non nephrotic proteinuria, isolated glomerular hematuria, renal masses, renal transplant rejection, connective-tissue diseases.

36
Q

Types of renal Biopsy

A

Percutaneous (needle)

Open - typically open is done if history of bleeding or blood clots in the past or if there is one kidney.

37
Q

Urinary Catheterization is utilized for

A

urinary drainage

often as a means of collecting urine for measurement

38
Q

Catheters that are left in (foley) are known as

A

Indwelling catheters

39
Q

what percentage of catheters placed in hospitalized pt’s are unwarranted

A

up to 50%

often these are utilized as convenience, understaffing, incorrect orders, low compliance to general rules, etc. complications arise including infections

40
Q

What are the actual indications for catheterization

A
  • Urinary retention with or without bladder obstruction
  • hourly urine output measurement
  • daily urine output for fluid management
  • intraoperative to assess fluid status
  • Neurogenic bladder
  • incontinence in pt with open wounds in sacral / perineal regions
41
Q

True or false - it is actually appropriate to utilize catheters for the incontinent pt’s as they can not control the release of their urine

A

false- other inappropriate uses include but are not limited to: obain urin in those who can spontaneously urinate, residual urinary bladder volume

42
Q

what is the timeframe that indicates greater risks of UTI with an indwelling foley

A

greater than 5 days with same indwelling foley there are higher risks of infection

43
Q

True or false- Collection of urethral specimens indicate the use of a swab with rotations in both directions of the urethra for a minimum of 10 seconds

A

False- one direction for 10 seconds

tips- insert swab gently 1-2 cm for women and 2-4 cm for men

** ensure you label the vial with the appropriate pt information

Genitourinary (11 decks)

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