Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Renal > Imaging Renal and Urological Disease > Flashcards

Imaging Renal and Urological Disease Flashcards

1
Q

What is renal colic usually caused by?

A

A ureteric calculus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Why must you be careful about organising tests to detect calculi?

A

They give high doses of radiation so you must ensure that the presentation of the patient is consistent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are some mimics of renal colic?

A

Pyelonephritis and gynaecological disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What investigation should be done if pyelonephritis or gynaecological disease are suspected?

A

Ultrasound

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What investigation should be done in a pregnant patient with suspected renal colic?

A

Ultrasound and/or MRI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are some features of renal calculi?

A

Most are rich in calcium and dense, some are calcium poor and of lower density (urate)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How may renal calculi be detected?

A

KUB x-ray, CT and MRI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the first line investigation for suspected renal colic?

A

KUB x-ray = easy to obtain and may show dense ureteric calculi

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is a drawback of using a KUB x-ray to investigate renal colic?

A

Only a minority of renal calculi are visible on this type of imaging
Lacks specificity and sensitivity for calculi

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What does a KUB x-ray view typically consist of?

A

Upper/mid abdomen = kidneys and proximal ureters

Pelvis = distal ureters and bladder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the normal course of the ureters?

A

Pass inferiorly over the psoas muscles and descend anterior to the tips of the lumbar transverse processes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What structure do the ureters cross before they enter the pelvis?

A

Iliac bifurcation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How do the ureters enter the bladder?

A

Pass posteromedially and enter the posterior aspect of the bladder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What can help make the renal collecting systems, ureters and bladder more visible?

A

IV urogram (IVU) = obtain x-ray following IV contrast injection/excretion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Where do ureteric calculi tend to get stuck?

A

Pelviureteric junction, pelvic brim, vesicoureteric junction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are mimics of ureteric calculi?

A

Phleboliths, lymph nodes, uterine fibroids and arterial calcification

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the definitive test to confirm a symptomatic ureteric calculus?

A

Non-contrast enhanced CT = shows virtually all calculi and signs of obstruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are some signs of obstruction that may be present due to a ureteric calculi?

A

Perinephric stranding and hydrourteronephrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are the issues of using a non-contrast enhanced CT?

A

Struggles to distinguish between small pelvic calculi and phleboliths when there are no secondary signs
Gives high dose of radiation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

In what groups should you avoid using a non-contrast enhanced CT?

A

Pregnant women and young female (where possible)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is done to follow up on renal colic?

A

Most calculi pass spontaneously

Use simple imaging test to check progress

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are some areas that macroscopic haematuria may arise from?

A

Kidneys, ureters, bladder or urethra

May be multi-focal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What are some causes of macroscopic haematuria?

A

Calculi, infection, tumour, urethritis, prostatitis, trauma, clotting disorders

24
Q

What investigations are done for patients over 50 who have macroscopic haematuria?

A

CT urography (CTU) and cytoscopy

25
Q

How is CT urography carried out?

A

Scan before contrast = to detect calculi
Administer IV contrast = concentrated/excreted by kidneys over 15 mins then top up dose given
Scan again = detects tumours

26
Q

What is the purpose of topping up the IV contrast during CT urography?

A

Enhances the renal parenchyma

27
Q

How is cytoscopy carried out?

A

Examines bladder and urethra = gives option for ureteroscopy (to confirm tumour where equivocal to CT or ablate tumours if unfit for nephroureterectomy)

28
Q

What are the benefits of MR urography?

A

Doesn’t require contrast or radiation = useful in patients with contrast allergy, renal impairment or pregnancy

29
Q

When is MR urography done?

A

When CTU is contra-indicated as less sensitive

30
Q

How do renal masses present?

A

May present with haematuria but most are incidental findings

31
Q

What imaging technique is used to assess renal masses?

A

CT = assesses size, density, uniformity and internal morphology

32
Q

How are renal masses that are <3cm managed?

A

Often followed up rather than operated on = rarely metastasise

33
Q

What are some examples of renal masses?

A

Benign angiomyolipomas = contain fat

Cysts = fluid density

34
Q

What are some features of malignant renal masses?

A

Complex cysts containing solid areas or thick septa

Solid masses > 3cm

35
Q

What can be used to image a simple cyst?

A

Ultrasound

36
Q

How are malignant tumours staged?

A

CT = assesses local extent, nodal disease and metastatic disease

37
Q

What are the classes of renal impairment?

A

Pre-renal, renal and post-renal

38
Q

How is pre-renal disease imaged?

A

MR angiography to detect RAS

39
Q

How is renal disease imaged?

A

Ultrasound to guide biopsy

40
Q

How is post-renal disease imaged?

A

US = shows hydronephrosis which accompanies obstruction

Other causes of obstruction require CT

41
Q

How is renal size assessed?

A

Ultrasound = distinguishes between acute and chronic

42
Q

How do the testes and epididymis appear on ultrasound in epididymo-orchitis?

A

Hypervascular

43
Q

What are some causes of a painful scrotum?

A

Epididymo-orchitis = viral/bacterial, may cause ischaemia or abscess formation
Testicular torsion and trauma

44
Q

What are some features of testicular torsion?

A

Young males, surgical emergency due risk of infarction, avascular testes on ultrasound

45
Q

What is the best investigation for a painless scrotal swelling?

A

Ultrasound

46
Q

What are some examples of painless scrotal swellings?

A

Variocoele, hydrocoele, epididymal cysts, testicular seminoma

47
Q

What are some features of variocoele?

A

Dilated scrotal venous plexus, typically left side, tortuous veins usually >2mm in diameter

48
Q

How do hydrocoeles appear?

A

Black anechoic fluid surrounds testicle

49
Q

What are some features of epididymal cysts and testicular seminoma?

A

Epididymal cysts = anechoic cyst, arise within the epididymal head
Testicular seminoma = intra-testicular soft tissue mass, often show vascularity

50
Q

How is renal trauma imaged?

A

Best assessed by CT = usually blunt trauma

51
Q

What are the types of bladder rupture?

A 
Extraperitoneal = common, treated conservatively
Intraperitoneal = due to compression of full bladder, needs surgery
52
Q

What is the mechanism for urethral injury in trauma?

A

Anterior pelvic fracture/dislocation or straddle injury

53
Q

What are some features of urethral trauma injuries?

A

Don’t attempt catherisation if suspected, role of imaging limited, may be complicated by long term stricture formation (defined by urethrography)

54
Q

What are some examples of non-vascular interventional uroradiology?

A

Relief of ureteric obstruction, drainage of abscess/cyst, biopsy of masses, guided ablation of tumours

55
Q

What are some examples of vascular interventional uroradiology?

A

Correction of renal artery stenosis, correction of arterial bleeding, variocoele embolisation

Renal (36 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions