GU Imaging Flashcards
Kidneys are about __ __ long.
10 cm
A patient is diagnosed with a Ureterocele–what is this? How does this appear on an IVP?
- a dilatation of the distal ureter
- appears as a “cobra head deformity” on IVP
When a patient has a Ureterocele, how dilated is their ureter?
8mm
What are some imaging studies used for the bladder?
IVP
cystogram
CT scan
What is a Cystoscopy? And when should you perform one?
- it is a bladder endoscope
- should be performed as an initial study for suspected bladder cancer
How is a cystoscopy performed?
a catheter is placed,
the urine drained and the contrast is injected into the bladder
A patient was in a horrible car accident and their pelvis has been fractured. The patient is also experiencing hematuria. What diagnosis should you suspect in this scenario?
-bladder rupture
OR
-bladder may be displaced by hematomas caused by the pelvic fracture
A patient was in a horrible car accident and their pelvis has been fractured. The patient is also experiencing hematuria. If the patient has their bladder elevated centrally–what should you suspect as the cause?
- BILATERAL hematoma caused by the pelvic fracture
- will have an upside down tear drop appearance
What type of rupture has extravasation of contrast into the peritoneal cavity that outlines loops of bowel?
Intraperitoneal rupture
What is the study of choice for bladder trauma?
CT
T/F Left Kidney is higher than the right kidney.
True
Superior pole of the kidney tilted ________; whilst the inferior pole is more ______.
medially; anterior
The IV contrast from an Intravenous Pyelogram interacts with _________and can cause lactic acidosis.
Glucophage (metformin)
For patients that are at risk for reaction to IVP, a _____ ______ may be performed.
Renal ultrasound
Renal ultrasounds are indicated for
hydronephrosis or renal masses.
Specific evaluation of the bladder is performed using a ________, in which contrast is injected via a catheter.
Cystogram
__ _____ is indicated as first line when IVP is contraindicated.
CT scan
What test is indicated for visible hematuria with known trauma?
CT scan
What are the three most common kidney CONGENITAL abnormalities?
- Ureteral duplication
- Pelvic kidneys
- Horseshoe kidney
It is very common to find ____ ______ ____ in most people over 60 years old.
simple renal cyst
US is good for benign renal cyst. However, If a renal cyst has septa____ ____ is indicated.
CT scan
In which classification of Bosniaks Categories are renal cysts 100% malignant?
Stage 4
5% of renal cysts are malignant in this stage of Bosniaks Categories.
Stage 2
Renal calculi larger than _ __ are likely to cause obstruction.
5 mm
What type of surgery is indicated for calculi greater than 5 mm?
Lithiotripsy
_____ ________ are large stones that fill up most of the collecting system.
Staghorn Calculi
Nyna Olveera comes into the clinic complaining of intense flank pain and is screaming like she is in labor. Upon urination , there is hematuria. What is the cause?
Renal Stone Disease
T/F It is clinically significant when an obstructing stone rupture the renal calyx .
False, there is NO clinical significance.
What is indicated for initial evaluation of renal failure?
Ultrasound
T/F IVP can cause worsening renal function.
True
This kidney disease presents with flank pain, fever, and pyuria.
Pyelonephritis
Imaging is only indicated for pyelonephritis when there is an _____, or the patient is ________.
abcess;diabetic
Fracture of the 12th rib or of the transverse process of the lumbar vertebrae
Instances in which kidney trauma should be suspected include:
Non-visualization of the psoas margin may also be a sign of ____ ______.
kidney trauma
What is the study of choice for renal trauma?
CT Scan
85% of renal CA is _____ ______carcinoma
renal cell
___ _____ is the study of choice for suspected renal tumors
CT scan
______is the best study to evaluate for obstruction of the collection system.
Ultrasound
Ectasia
Simple dilatation of the renal collecting system WITHOUT obstruction is called
What study is indicated for recurrent cystitis in females and for initial episode of cystitis in males?
IVP
True or False: emphysematous cystitis is when gas is present in the wall or lumen of the bladder
True
True or False: Diabetic patients cannot have emphysematous cystitis.
False
Most (95%) of bladder tumors are what type of cancer?
transitional cell carcinomas
A patient is admitted with hematuria, +/- dysuria and frequency–what should be among your most fatal suspicions?
Bladder tumor
A patient with hematuria, dysuria is diagnosed with transitional cell carcinoma. What is the study of choice for this CA?
Why would you NOT use an IVP?
Why would a CT come useful in this scenario?
- cystoscopy (for direct visualization)
- IVP may show filling defect
- CT scan is useful for evaluation of surrounding tissue and lymph nodes
True or False: No imaging is needed for evaluation of BPH or prostatitis.
True
BPH has what effect on the bladder?
- can cause elevation
- can be seen on an IVP
While viewing a male patient’s IVP, you notice a smooth defect on the inferior portion of the bladder. What would this indicate?
BPH
True or False: CT and MRI have limited use in prostate cancer.
True
If a patient needs evaluation of possible bone metastases, what is the best study of choice?
Bone scan
What use does a Transrectal ultrasound have?
-useful for evaluating a suspicious area of the prostate
What is the first line study for any testicular problem?
Ultrasound
What used to be the gold standard but is rarely used anymore in testicular pain and masses?
Nuclear medicine testicular scan
What 2 tests are indicated for staging of testicular cancer?
CT and CXR
What is the most common and useful study of the female pelvis?
U/S
Why would you use a hysterosalpingogram (HSG)?
to evaluate the potency of fallopian tubes
What is the study of choice for imaging during pregnancy?
Ultrasound
What are some indications for an U/S?
- Size/date discrepancy
- Vaginal bleeding
- Suspected congenital abnormalities
- Maternal disease
- diabetes,
- HTN,
- renal or heart disease
- Suspected fetal demise
- Preterm labor or ruptured membranes
How many days for the gestational sac to develop?
28-30 days
How many days for the yolk sac and heartbeat to develop?
5-6 weeks
A female patient comes in with pain, bleeding and + HCG test. It has been over 5 weeks, but no gestational sac or heartbeat were seen in the uterus. What diagnosis would you suspect?
ectopic pregnancy
How is cervical cancer usually detected?
PAP smear
How do you evaluate Endometrial cancer ?
it is difficult to assess by radiological studies – an EMBx is necessary
What is the most common benign uterine tumor?
fibroid – often calcified and seen on plain films
True or False: There is no effective screening for ovarian cancer.
True
True or False: Benign and malignant ovarian tumors CANNOT be bilateral.
False
-they CAN be bilateral
True or False: Clinical presentation of ovarian tumors may be bloating or weight gain due to ascites.
True
What test is taken to evaluate the ovarian tumor and assess for mets?
CT scan
What is the study of choice for imaging for suspected retroperitoneal adenopathy?
CT
What is the imaging study of choice for adrenal glands?
CT
What type of cancers metastasize to the adrenal glands?
Lung,
breast,
gastric,
colon and renal cancers all metastasize to the adrenals
Two ways to screen for prostrate
Screening done by digital rectal exam or PSA
How do you locate the prostate?
Transrectal Ultrasound
Testicular torsion is a….
surgical emergency!!
When you see a normal appearing uterus with a complex adnexal mass..you should suspect?
Ectopic Pregnancy
Most common benign tumor of the pelvis
Fibroid
