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Renal SB > Imaging > Flashcards

Imaging Flashcards

1
Q

if pyelonephritis is suspected, what investigation should be done

A

US
- to exclude ureteric obstruction
Then Contrast-CT

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2
Q

if a gynaecological disease is suspected, what investigation should be done

A

US

- to visualise uterine, ovarian and uterine tubal pathology

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3
Q

when is an US (or MRI) done instead of a CT

A

patient is pregnant

- avoid radiation exposure to foetus

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4
Q

Renal colic Ix

A

1st - Non contrast CT
2nd - KUB x-ray

If CT contraindicated then MRI

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5
Q

what is the normal ureter course

A

Pass inferiorly over the psoas muscles

Descend anterior to the tips of the lumbar transverse processes

Cross the iliac bifurcation and enter the pelvis

Pass posteromedially and enter the posterior aspect of the bladder

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6
Q

where do ureteric calculi often get stuck at

A 
pelviureteric junction (PUJ)
pelvic brim
vesicoureteric junction (VUJ)
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7
Q

what are the flaws in KUB x-ray

A

lacks specificity

- phleboliths, lymph nodes, uretine fibroids and arterial calcification are also shown

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8
Q

what are phleboliths

A

calcification within a vein

- of no clinical importance

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9
Q

what is the definitive test to confirm SYMPTOMATIC ureteric calculus

A

Non-contrast enhanced CT

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10
Q

when is CT avoided

A

In pregnant females
if possible, non-preganant young females
contrast induced nephropathy

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11
Q

how can renal colic be followed up

A

by using the simplest test that showed the calculus at presentation

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12
Q

what is the aim in macroscopic haematuria investigation

A

to examine the whole urinary tract by simplest means possible

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13
Q

Ix of frank haematuria in the over 50s

A

1 - CT urography (CTU)

2 - Cystoscopy

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14
Q

what does the CTU look at

A

the kidneys, collecting systems and ureters

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15
Q

what does the cystoscopy examine

A

the bladder and urethra

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16
Q

what is the CTU technique

A

First CT scan before contrast
Administration of IV contrast (wait 15 mins)
Top up dose of IV contrast
Second CT scan

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17
Q

what can be seen in the first CT scan before contrast

A

renal or ureteric calculi

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18
Q

what can be seen in the second CT scan with contrast

A

renal parenchymal tumours

urothelial tumours of the collecting systems or ureters

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19
Q

what is an advantage of finding a tumour on a CT scan with contrast

A

any tumour detected can be staged at the same time

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20
Q

Ix of the under 50s with macroscopic haematuria

A

US of kidneys to detect calculi and renal parenchymal tumours

Cystoscopy to look for occasional bladder TCC, bladder calculi, other bladder tumours or evidence of urethritis/prostatitis

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21
Q

when is a CTU done in under 50s with macroscopic haematuria

A

only when US and cystoscopy are normal and macroscopic haematuria persists

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22
Q

when is MR urography useful

A

as it does not require contrast or radiation, useful in patients who have;

  • contrast allergy
  • renal impairment
  • pregnancy
23
Q

when is MR urography used

A

when CTU contra-indicated

24
Q

how are most renal masses detected

A

incidentally when imaging for another reason

25
Q

when is a renal mass not investigated

A

when it is

26
Q

what is used to assess a large renal mass

A

CT scan

27
Q

what are benign masses containing fat and blood vessels

A

angiomyolipomas

28
Q

how are angiomyolipomas treated

A

only removed if very large

no malignant potential but can burst and bleed

29
Q

what are fluid density masses called and what is the best way to image them

A

simple cysts

US

30
Q

what imaging is best for complex cysts

A

US

31
Q

what can be used to image renal masses if CT cannot be used

A

MR with contrast

32
Q

where can kidney cancer metastasis to and what does it appear as

A

to the lung

cannon ball mets

33
Q

what is used to investigate Renal artery stenosis

A

MR angiography

34
Q

if renal impairment is due to renal cause what is used to investigate it

A

US guided Biopsy

35
Q

what suggest chronic disease of the kidneys

A

If they appear small on an Ultrasound

36
Q

what can show hydronephrosis

A

US

37
Q

what is needed to investigate post renal causes of impairment (apart from hydronephrosis)

A

CT scan

38
Q

what can cause hydronephrosis apart from obstruction

A

ureteric reflux

39
Q

what are causes of the painful scrotum

A

epididymo-orchitis
testicular torsion
trauma

40
Q

what is epididymo-orchitis and what can cause it

A

inflammation of the epididymis and/or testis

can be caused chlamydia, viral or bacteria infection

41
Q

what can complicated epididymo-orchitis

A

abscess formation or rarely ischaemia

42
Q

what are symptoms of epididymo-orchitis

A

sudden-onset tender swelling
dysuria
sweats/fever

43
Q

Ix of epididymo-orchitis

A

US

- the testis and/or epididymis is typically hypervascular

44
Q

how does testicular torsion normally appear on IS

A

avascular

45
Q

what are causes of painless scrotal swelling

A

hernia
varicocoele
hydrocoele
epididymal cyst

46
Q

what is the investigation of choice for scrotal swellings

A

US

47
Q

what is varicocele

A

veins become enlarged inside your scrotum

48
Q

what is hydrocoele

A

build up of fluid around the testicles

49
Q

how is renal trauma best imaged

A

CT

50
Q

how is bladder rupture diagnosed

A

Cystography

CT cystography

51
Q

what should not be attempted if urethral disruption is suspected

A

cathererisation

52
Q

Ix for urethral trauma

A

Urethrography

53
Q

what could ureteric obstruction be treated

A

NEPHROSTOMY

- artificial opening created between the kidney and the skin

54
Q

in macroscopic haematuria what is the two investigations

A

CT urography for upper tracts

Cystoscopy for lower tract

Renal SB (15 decks)

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