HomeStretch CRACK vol 1. GU/Repro Flashcards
Mayer-Rokitasky-Huster-Hauser Syndrome
Mullërian agenesis
What is the most senstive contrast phase to detect RCC?
Nephrographic phase (~80 seconds)
RCC Subtypes
Clear Cell: Most common; VHL
Papillary: Second most common, less aggressive, on T2 dark ddx, hereditary papillary renal carcinoma, transplant kidney
Medullary: Sickle Cell TRAIT; bad prognosis
Chromophome: Birt Hogg Dube
Translocation: Most common subtype in kids; prior cytotoxic chemo
Bourneville Disease
Tuberous Sclerosis
“Tuberous Bourneville Sclerosis”
T2 Dark Renal Cyst DDx
Lipid poor AML
Hemorrhagic cyst (these will be T1 bright)
Papillary subtype RCC
Medullary sponge kindey syndromic associations
Ehlers-Danlos
Caroli’s
Beckwith-Wiedeman
Vascular complications of renal transplant
What are they, when do they happen?
- Renal vein thrombosis - within first week - can show renal artery doppler with reversed diastolic flow
- Renal artery thrombosis - within first month (or post op)
- renal artery stenosis = seen within first year - refractory HTN
- PSV > 200-300m/s
- PSV Ratio > 1.8-2.5x
- Tardus parvus
- anastomatic jetting
- Most common RCC subtype in renal transplant?
- PTLD associated virus and drug
- Renal transplant + BK Virus = ?
- Papillary
- EBV; rituximab
- urothelial cancer
Renal trauma grading
- grade I: subcapsular hematoma or contusion, without laceration
- grade II: superficial laceration ≤1 cm depth not involving the collecting system (no evidence of urine extravasation); perirenal hematoma confined within the perirenal fascia
- REMEMBER THIS ONE: grade III: laceration >1 cm not involving the collecting system (no evidence of urine extravasation) vascular injury or active bleeding confined within the perirenal fascia
- grade IV: laceration involving the collecting system with urinary extravasation laceration of the renal pelvis and/or complete ureteropelvic disruption vascular injury to segmental renal artery or vein; segmental infarctions without associated active bleeding (i.e. due to vessel thrombosis); active bleeding extending beyond the perirenal fascia (i.e. into the retroperitoneum or peritoneum)
- grade V: shattered kidney; avulsion of renal hilum or laceration of the main renal artery or vein: devascularisation of a kidney due to hilar injury; devascularised kidney with active bleeding
Malakoplakia vs leukoplakia
Malakoplakia = NOT premalignant; michaelis-gutmann bodies, often in immunocompromised females
leukoplakia = premalignant. . “ew”
Ormond disease
Retroperitoneal fibrosis
Subepithelial renal pelvis hematoma
mimmic for TCC
happens in patients on long-term anticoagulation or hx of hemophilia
hyperdense blood clot in renal pelvis that does not enhance
Eagle-Barrett Syndrome
prune belly syndrome
verumonatanum
ovoid mound that lies in the posterior wall of the prostatis urethra and contains the prostatic utricle
fossa navicularis
Most anterior portion of the urethra
Bladder cancer and Urethral Cancer BLITZ!
- Transitional (urothelial) cell CA
- most common in subtype in bladder and prostatic urethra (thick about it like a bladder CA)
- Squamous cell CA
- In the bladder it is associated with Schistosomiasis and Suprapubic catheter/urinary stasis
- Seen in bulbar/penile urethra cancers (think of the squamous cells from the head of penis growing inward - HPV style)
- AdenoCA
- Midline, associated with urachal remnant and bladder extrophy
- also associated with urethral diverticulums (think of these almost as urachal remnants).
Uterus didelphys
fusion failure with complete uterine duplication
This is the one with a vaginal septum
Unicornuate uterus
Failure to form, therefore has u/l renal issues
has 4 variants: isolated, +noncavitary rudimentary horn, +communicating cavitary horn, +noncommunicating cavitary horn
best time for HSG?
proliferative phase (day 7-12)
The critical stage for endometrial cancer?
Stage 1 -> stage 2
Stage 2 is defined by cervical stromal invasion
The critical stage for cervical cancer?
Stage IIA - Stage IIB
spread beyond the cervix + parametrial invasion
2B or not 2B?!
cumulus oophorus
collection of cells in a mature dominant follicle that protrudes into follicular cavity and signal imminent ovulation
best time to do PET in premenopausal person
the first week of menstrual cycle
decidualized endometrioma
solid nodule with blood flow in and endometrioma of a pregnant girl
(same findings without pregnancy = malignant degeneration).
What does T2 shading of an endometrioma refer to?
T2 shortening (darker) of a lesion that is T1 bright
rare cancer transformation subtypes
Endometrioma -> ?
Dermoid -> ?
Endometrioma -> Clear Cell
Dermoid -> squamous cell
MRI characteristics of Hemorrhagic cyst, endometrioma and dermoid
Hemorrhagic Cyst: bright on T1, T1FS and T2
Endometrioma: Bright on T1, T1FS and “shading” on T2 (ie dark)
Dermoid: Bright on T1 and T2, and then fat sats out
Meigs syndrome
triad of ascites, pleural effusion and benign ovarian tumor (fibroma).
Critical stage point for prostate cancer
Stage II versus stage III
extracapsular extension = stage IIIa
stage IIIb is when you get seminal vesicles and nerve bundle extension
Zinner syndrome
triad of mesonephric (wolffian) duct anomalies
u/l renal agenesis, i/l seminal vesicle cyst and ejaculatory duct obstruction
Syndromes associated with male infertility
- Pituatary adenoma (increase prolactin)
- Kallman syndrome (can’t smell + infertile)
- Klinefelter syndrome (tall + gynecomastia + infertile)
- Zinner syndrome (u/l renal agensis, i/l seminal vesicle cyst and ejaculatory duct obstruction)
- CF - absent vas deference
- Immotile ciliary syndrome
if you see an aplastic or hypoplastic humeral head in a kid, what should you think?
Erb’s palsy
When is nuchal lucency measured? Whats the upper limit of normal?
How about nuchal fold thickness?
Nuchal lucency: 9-12 weeks; should be < 3mm to be normal
Nuchal thickness: 2nd trimester; < 6mm is normal
