Lesson 4D (Part 1)

Question 1

What are cortical cysts known as?

Answer 1

Simple cysts

Question 2

What are 6 characteristics of simple cysts?

Answer 2

1. Benign
2. Fluid filled
3. Anechoic
4. Sharp defined borders
5. Round or ovoid
6. Posterior enhancement

Question 3

Are simple cysts symptomatic or asymptomatic?

Answer 3

Asymptomatic

Question 4

What can large cysts potentially cause? (2)

Answer 4

1. Flank pain

2. Hematuria

Question 5

What are 4 characteristics of complex cysts?

Answer 5

1. Contain internal echoes
2. Septations
3. Calcifications
4. Mural nodularity

Question 6

What do most complex cysts require? (2)

Answer 6

1. CECT
2. MRI

• for follow up

Question 7

What are internal echoes a result of? (2)

Answer 7

1. Hemorrhage

2. Infection

Question 8

What do thickened cyst walls, debris filled/ gas fluid level infection require? (2)

Answer 8

1. Aspiration

2. Drainage

Question 9

What do septations result from? (3)

Answer 9

1. Hemorrhage
2. Infection
3. Previous percutaneous aspiration

Question 10

What are septations considered as?

Answer 10

Benign

- thin, smooth septa attached to a thin wall

Question 11

What is a thick septa considered as?

Answer 11

> 1 cm

Question 12

What is an ominous sign?

Answer 12

Complex cysts with thick septa > 1cm and thick wall attachment

Question 13

What is the best modality for characterizing cysts?

Answer 13

US

Question 14

What is not indicated in multiseptated cysts?

Answer 14

Aspiration

Question 15

What do thin walls or septal calcification suggest?

Answer 15

A complicated cyst

- rather than malignancy

Question 16

What type of calcification is more worrisome?

Answer 16

Thick irregular amorphous calcification

Question 17

If solid enhancing components are seen on CT what is a recommended?

Answer 17

A prompt reaction

Question 18

What does surgical removal only exclude?

Answer 18

Malignancy

Question 19

What kind of cyst is a milk of calcium cysts?

Answer 19

Benign

Question 20

What does a milk of calcium cyst mimic?

Answer 20

Cyst wall calcification

Question 21

What does milk of calcium cysts look like on US? (2)

Answer 21

1. Bright echogenic foci

2. Ring down artifact

Question 22

What does CT not pick up with milk of calcium cysts?

Answer 22

Calcification

Question 23

What does parapelvic cysts not communicate with?

Answer 23

The collecting system

Question 24

What does parapelvic cysts mimic?

Answer 24

Hydronephrosis

- so take care to show noncontinuity with collecting system

Question 25

What do parapelvic cysts look like on US? (3)

Answer 25

1. Well defined
2. Anechoic
3. Renal sinus masses

Question 26

What can help differentiate parapelvic cysts?

Answer 26

CECT

Question 27

What are examples of renal cystic diseases? (8)

Answer 27

1. ADPKD
2. ARPKD
3. Tuberous sclerosis
4. Medullary spong kidney
5. Von-Hoppel lindau disease
6. Medullary cystic diseases
7. Acquired cystic kidney disease
8. Multicystic renal dysplasia

Question 28

ADPKD

Answer 28

Autosomal dominant polycystic kidney disease

Question 29

What is the most common hereditary renal disorder?

Answer 29

Autosomal dominant polycystic kidney disease

Question 30

What does ADPKD result in?

Answer 30

A large number of bilateral cortical and medullary renal cysts

Question 31

What are ADPKD patients at risk for?

Answer 31

RCC

Question 32

What are 4 S/S of ADPKD?

Answer 32

1. Palpable masses
2. Pain
3. Hypertension
4. Hematuria UTI’s

Question 33

What % of renal failure occurs with ADPKD?

Answer 33

50%

- by age 60

Question 34

What are complications with ADPKD? (5)

Answer 34

1. Infection
2. Hemorrhage
3. Stones
4. Obstruction
5. Cyst rupture

Question 35

What kind of cysts occur in ADPKD? (3)

Answer 35

1. Liver cysts
   - 30-60%
2. Pancreatic cysts
   - 10%
3. Splenic cysts
   - 5%

Question 36

What do ADPKD cysts look like? (3)

Answer 36

1. Very enlarged kidneys
   - >20cm
2. Multiple bilateral cysts of varying sizes
3. Little cortex is visible