Imaging

Question 1

What is a KUB? Used for? Pros?

Answer 1

• kidney, ureter and bladder: plain frontal supine radiograph of the abdomen
• used to help ID stones (can see stones that are 4 mm and larger)
• helps to assess constipation in ped pts
• Also can look at platelet of stents
• inexpensive

Question 2

What is an IVP? Used for?

Answer 2

• xray done with IV contrast to look at kidneys, ureters and bladder
• used for:
  abdominal injury
  bladder and kidney infections
  hematuria
  flank pain
  tumors

Question 3

Risk of IVP?

Answer 3

• allergic rxn
• pt will have to void b/f and after study
• a series of images will be taken at various times to look at filtration
• CT IVP has replaced traditional IVP

Question 4

Diff US used in urology?

Answer 4

• renal
• prostate
• scrotal

Question 5

Use of renal US?

Answer 5

• size of kidneys
• signs of injury to kidneys
• abnormalities present at birth
• presence of blockage or kidney stones
• complications of UTI
• cysts or tumors

Question 6

Use of scrotal US?

Answer 6

• look at size of testicles
• to eval mass or lump (cystic vs solid) (see hydrocele, vericocele - use doppler)
• find reason for pain if PE was normal
• look at blood flow to testicles
• look for location of undescended testis

Question 7

Use of prostate US?

Answer 7

• called trans-rectal US (TRUS)
• detect disorders w/in prostate
• measure the prostate
• help distinguish cause of man’s infertility (ejac duct problem?)
• eval prostate nodules: needle bx
• placement of needles for radiation

Question 8

What is a VCUG?

Answer 8

• an xray study of bladder using fluoroscopy and contrast material
• used to check for vesicoureteral reflux after a UTI
  also used for:
• bladder obstruction
• abnormal urinatrion w/ very high pressure w/in bladder
• incomplete bladder emptying
• done mainly in kids who have recurrent bladder infections or pyelonephritis, feverish UTI

Question 9

What is a RUG? Used for what?

Answer 9

• retrograde urethrogram
• more commonly used in male pts
• helps dx urethral pathology from trauma or urethral strictures
• done for pre and post-op reconstruction of the urethra
• can help ID urethral diverticulum and fistulas

Question 10

If pt presents to ER from trauma and see blood at meatus what should you think? How would you dx?

Answer 10

• urethral tear

- use RUG

Question 11

Use of CT for dx renal stones?

Answer 11

• no contrast dye is used
• Gold std to detect stones
• detects all types of stones: even uric acid stones - (if you did KUB first saw nothing - know it’s uric acid)
• gives the exacty shape, size, and location of stone (only painful when in ureter)

Question 12

Drawbacks to using CT scan for dx renal stones?

Answer 12

• radiation exposure

- cost

Question 13

Use of IVP CT scan?

Answer 13

• use IV contrast dy
• eval collecting system, ureters, and bladder
• used for causes of hematuria
• ID renal tumors better than CT w/o contrast

Question 14

Drawbacks to IVP CT?

Answer 14

• radiation exposure
• cost
• allergy to contrast dyes
• renal disease

Question 15

Use of radionuclide imaging?

Answer 15

• renal scan: use 2 diff radiopharm: DTPA, MAG3
• looks at blood supply, fxn, and excretion of urine from kidney
• used mainly by urologist to eval hydronephrosis - UPJ obstruction? Is kidney repairable?

Question 16

benefits and risks of radionuclide imaging?

Answer 16

- benefits:
provides info unattainable by other imaging, helps with dx and management
- risks:
low radiation exposure
allergic rxns

Question 17

Use of MRI for eval of prostate?

Answer 17

• used mainly for prostate cancer
• helps determine extent of spread of cancer - has it spread outside of the capsule?
• helps in planning radiotherapy for prostate cancer