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Y2 - Urinary > Lecture 22 - Imaging > Flashcards

Lecture 22 - Imaging Flashcards

1
Q

What vertebral levels do the kidneys lie between?

A

L1 - L3

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2
Q

What do you remember to analyse an abdomen x-ray?

A

ABDO X

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3
Q

What does ABDO X stand for when analysing an abdomen x-ray?

A

A = air
B = bowel
D = dense structures and calcification
O = organs and soft tissues

X = eXternal objects, lines and tubes

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4
Q

Slide 3: Image 1

What is the abnormality?

What wll the patient experience?

A

Renal stone in right ureter

Right sided loin to groin pain

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5
Q

What are renal stones most commonly made of?

A

Calcium Oxalate / phosphate

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6
Q

What are some ways of identifying renal tract stones?

A

CT (kidneys, Ureter and bladder)

US for hydronephrosis

MRI for pregnancy

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7
Q

What are some complications of renal stones?

A

Infection
Urine leak

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8
Q

What is steinstrasse?

A

Translates to stone street

When there are multiple stones (usually fragments) in the distal ureters post-lithotripsy
They are usually small fragments of stones in a row

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9
Q

Slide 4 X-ray 2:

What is the abnormality?

How does the patient present?

A

Steinstrasse

Multiple renal stones in the distal ureter

Urine retention
Pain
May get infection

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10
Q

Slide 4 X-ray 3:

What is the abnormality?

How does the patient present?

A

Right sided kidney mass (swollen indistinct kidney)

Could be renal cell carcinoma

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11
Q

Slide 4 X-ray 4:

What is the abnormality?

How does the patient present?

A

Left sided accessory ureter

Asymptomatic (usually an incidental finding)

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12
Q

Slide 4 X-ray 5:

What is the abnormality?

What is this?

A

Cystectomy

Where the bladder is removed and the ureters are put into the ileum (ilisotomy)

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13
Q

What is Fluroscopy?

A

Series of moving x-rays

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14
Q

Slide 4 Fluroscopy 6:

What is the abnormality?

How does the patient present?

A

Diverticula

Prolapse of bladder mucosa through bladder wall

Asymptomatic unless become inflamed or infected

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15
Q

What is ultrasounds used to image?

A

Hydronephrosis
Stones

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16
Q

How are the dark areas on ultrasound described?

How are the light areas on ultrasound described?

A

Dark = hypoechoic
Light = hyperechoic

17
Q

Slide 5 ultrasound 7:

What is the abnormality?

How does the patient present?

A

Diverticula of bladder

Asymptomatic

18
Q

If a patient has a renal tract stone how should they lie in the CT scanner and why?

A

Lie on their front

Ureters enter the bladder posteriorly
Therefore by lying patient on their front it means if stone is stuck in ureter it’ll stay where it is, if its in the bladder it will fall and press against the anterior wall of the bladder

19
Q

Slide 5 CT 8:

What is the abnormality?

How does the patient present?

A

Left sided ureteric stone

Loin to groin pain
Can get infection
Could eventually develop into hydroureter then hydronephrosis

20
Q

Slide 5 CT 9:

What is the abnormality?

How does the patient present?

A

Horseshoe kidney (where the poles of the kidneys fuse)

Asymptomatic but the kidney is vulnerable to trauma

21
Q

What vertebral level does a horseshoe kidney reside at and why?

A

L3
Since it gets trapped by the inferior border of the inferior mesenteric artery branching from the aorta

22
Q

What is the most common type of renal tract malignancy?

A

Renal cell carcinoma

23
Q

What is the use of CT n Renal Cell carcinoma?

A

Measure invasion and metastases

24
Q

What is the use of US for renal cell carcinoma?

A

Screening for haematuria and biopsy guidance

25
Q

Why are MRIs used with renal cell carcinoma?

A

Used specifically to assess and follow up cystic lesions

26
Q

What is the most next common types of renal tract malignancy following renal cell carcinoma?

A

Transitional cell carcinoma (ureteric cancer/urothelial cell carcinoma)

27
Q

What imaging is done for transitional cell carcinoma and why?

A

CT = locate measure and follow up

US = for hydronephrosis

Fluroscopy = nephrostomy

28
Q

What is crossed fused ectopia?

A

Where the 2 kidneys end up being fused together so 1 side is without a kidney

29
Q

What are patients with crossed fused ectopia at risk of?

A

Stones
Infection
Hydronephrosis

30
Q

What is the most common anatomy anomaly?

A

Duplex collecting system

So can be 2 renal pelvises, bifold ureter or double ureters

31
Q

Slide 7 CT 10:

What is the abnormality?

How does the patient present?

A

Right sided pyelonephritis
Kidney is swollen and has poor contrast uptake

Fever
Flank pain
Nausea or vomiting
Pain on urination
Urgency

32
Q

Slide 7 CT 11:

What is the abnormality?

A

Calcification in kidney

33
Q

Slide 7 CT 12:

What is the abnormality?

How does the patient present?

A

Right sided kidney injury due to trauma

Blood in perinephric space visible

34
Q

What is bright in a T1 MRI?

What is bright in a T2 MRI?

A

T1 = fat

T2 = fluid (water/H20. H two 0, T Two)

35
Q

Slide 13 MRI 13:

What is the abnormality?

How does the patient present?

A

Polycystic kidney Disease (PKD)

30-40yrs
Hypertension
Acute loin pain
Haematuria
Bilateral palpable kidneys

36
Q

What imaging procedure is usually done to aid a nephrostomy?

A

X-rays/fluroscopy

37
Q

Slide 7 Image 14:

What is the abnormality?

A

Crossed fused ectopia

Y2 - Urinary (24 decks)

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