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Body Imaging > Kidneys > Flashcards

Kidneys Flashcards

1
Q

Imaging findings AML

A

Hyperechoic, post acoustic shadowing on US
Most contain fat!! (5% are fat poor)
India ink artifact on MR
Multiple = TS

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2
Q

DDx fat poor AML

A
  • RCC (often has calcs, focal or diffuse signal loss seen in clear cell as opposed to india ink artifact)
  • Retroperitoneal liposarcoma (look for large feeding vessel, renal parenchymal defect/claw sign - both seen in AML)
  • Oncocytoma
  • Wilms
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3
Q

Imaging findings oncocytoma

A

Can look similar to RCC (for this reason they are excised)
Round, circumscribed, spoke wheel pattern of vessels +/- central fibrous scar
Need to remove, bx not helpful as RCC also has oncocytic elements

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4
Q

Imaging appearances of TB

A

If you see 3 or more of:

  • renal calcification
  • infundibular stricture
  • papillary necrosis
  • caliectasis
  • renal scarring
  • irregular urothelial thickening

suggest TB!

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5
Q

Imaging findings in XGP

A

Enlarged kidney, loss of corticomedullary differentiation, dilated calyces (bear paw), large staghorn calculus

DDx: Renal TB

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6
Q

Imaging findings HIV nephropathy

A

Enlarged, echogenic kidneys

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7
Q

Other associations with ADPKD

A
  • Cerebral aneurysms (5-15%)
  • Cyst in liver, seminal vesicles, pancreas, spleen
  • Hypertension
  • Cardiac (mv prolapse, bicuspid AV**, dissection)

NB: no increased risk of RCC (but acquired cystic disease from long term renal failure/dialysis does have increased RCC risk)

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8
Q

List the complications seen on imaging post renal transplant

A
  • Renal Transplant Compartment Syndrome (RTCS)
  • AVF or pseudoaneurysm post-bx
  • Ureteral obstruction
  • Fluid collection (hematoma immediate-5 days, 10 days urinoma, weeks to months abscess, 2wks-6mos lymphocele)
  • Renal artery thrombosis (rare, immediate post-op)
  • Renal vein thrombosis (immediately post op to 5 days)
  • Renal artery stenosis (3 months to 2 years after surgery)
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9
Q

Frequency of PTLD in renal transplants? Cause? Imaging appearance?

A

1-3% (can be up to 20% in non-renal transplants)
EBV virus in immunocompromised host
Solitary or multiple low attenuation masses
May encase hilum

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10
Q

Causes of medullary calcinosis

A 
HAMHOP
HyperPTH
Acidosis (RTA) - distal, type 1
Medullary sponge kidney
Hypercalcemia (MM, bone mets)
Oxalosis
Papillary necrosis
Child: furosemide
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11
Q

Causes of cortical nephrocalcinosis

A 
COAG
Cortical necrosis
Oxalosis
Alport syndrome
Glomerulonephritis
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12
Q

Weigert-Meyer rule

A

Upper moiety OBSTRUCTS (has ectopic insertion medial and inferior to normal ureter +/- ureterocele)
Lower moiety REFLUXES

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13
Q

Causes/RFs for papillary necrosis

A
  • Diabetes
  • Analgesic abuse, high dose NSAIDS
  • Sickle cell
  • Chronic infection (TB, pyelonephritis)
  • Renal vein thrombosis
  • Obstructive uropathy
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14
Q

Imaging findings of papillary necrosis

A

Nephrographic phase - reduced perfusion in papilla

Excretory phase - ball on tee, lobster claw sign (forniceal blunting), sloughed papilla, calyceal blunting/clubbing

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15
Q

What are Hutch diverticula?

A

Diverticula located at the UVJ, congenital containing all 3 layers of bladder wall, contiguous with the bladder lumen, cause of reflux in boys and young men

(ddx: acquired bladder diverticula)

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16
Q

Type of malignancy that forms in urethral diverticulum

A

Adenocarcinoma

17
Q

Location of skene duct cyst

A

Adjacent to external urethral meatus, below level of pubic symphysis (inflammatory obstruction of peri-urethral ducts)

18
Q

What is page kidney?

A

Systemic HTN secondary to extrinsic compression of kidney by sub-capsular collection

19
Q

Most common location of fused kidney in crossed fused renal ectopia? Where does ectopic kidney fuse?

A

Left side, lower pole

20
Q

DDx for plaque like thickening of renal pelvis and collecting system

A

Urothelial cell ca
Malakoplakia (chronic granulomatous infection causing multi-focal plaques)
Ureteritis cystica
TB

21
Q

Risk factors urothelial cell cancer

A

Smoking**
Chemical exposure
Cyclophosphamide

22
Q

Which bugs cause XGP?

A

Proteus, E.coli (sometimes staph)

23
Q

Pathologic findings in XGP

A

Mass like collection of lipid-laden macrophages

24
Q

Imaging findings in XGP

A

Staghorn calculus
Contracted renal pelvis
Dilated calyces
**Soft tissue/perinephric extension

25
Q

Most common cause of vas deferens calcification

A

Diabetes (ddx: TB, schistosomiasis)

26
Q

Causes of renal artery stenosis

A 
Atherosclerosis 
FMD
Dissection
Vasculitis 
NF

Body Imaging (11 decks)

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