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a Prometheus book FRCR Part 2A flashcards > Module 4 - Genito-urinary > Flashcards

Module 4 - Genito-urinary Flashcards

1
Q

difference in shape of adrenals

A

right is triangular
left is crescentic

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2
Q

shape of adrenal if kidney is absent

A

pancake

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3
Q

number of arteries to adrenals

A

3 to each

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4
Q

arteries arise from where to get to the adrenals

A

superior from the inferior phrenic
middle from aorta
inferior from renal artery

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5
Q

adrenal gland drainage

A

right to IVC
left to renal vein

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6
Q

anatomy of adrenal gland into two areas

A

cortex and medulla

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7
Q

cortex of adrneal gland can b broken into

A

Zona
- glomerulos
- fasciculata
- reticularis

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8
Q

What does each zone of the adrenal make

A

Glomerulos
- Aldosterone

Fascilculat
- Cortisol

Reticularis
-androgens

medulla
- catecholamins

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9
Q

Adrenal appearance onf US
(normally only seen in in babies)

A

bright cortex
dark medulla

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10
Q

causes of adrenal hypertrophy

conditions

A

21-hydroxylase deficiency

cushing syndrome

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11
Q

21 hydroxylase deficiency - how does it manifest

A

genital ambiguity in girls
salt losing nephropathy in boys

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12
Q

how does 21 hydroxylase deficiency look on US

A

loss of central hyperechoic stripe
adrneal limb width greater than 4mm

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13
Q

cushing syndrome - caused by what?

A

too much cortisol.
pituitary adenoma (disease).
Small cell lung cancer

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14
Q

How does adrenal haemorrhage manifest itself with stress in neonates?

A

fetal distress as trigger.
appearance based on timing since bleed.

calcification is end result

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15
Q

haemorrhage in adrenal gland as an adult - more common on which side?

A

right

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16
Q

Waterhouse-Friderichsen syndrome is what

A

haemorrhage of adrenal in the setting of fulminant meningitis

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17
Q

waterhouse -friederichsen caused by what organism?

A

Neisseria meningitiidis

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18
Q

PHaeo appearance on CT

A

heterogenous

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19
Q

Phaeo on MRI

A

bright T2

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20
Q

Which nuc med tests can be used for phaeo

A

MIBG and octreatide

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21
Q

Phaeo rule of 10s

A

10% are
extra adrenal
bilateral
in kids
hereditory
benign

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22
Q

Phaeo is ax with what syndromes?

A

VHL
Men 2a and 2b

NF1
sturge weber
Tuberous sclerosis

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23
Q

What is carney triad

A

extra adrenal phaeo
GIST
pulmonary chondroma

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24
Q

what is carney complex

A

cardiac myxoma and skin pigmentation

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25
Q

adenal myolelipoma - appears as what

A

fat
can be large
can bleed

ax with endocrine disorders

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26
Q

what mets to adrenal glands

A

breast
lung
melanoma

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27
Q

adrenal cortical carcinoma

size
features

A

large 4cm to 10cm
calcify in 20%

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28
Q

how to work out an adenoma on CT?

A

percentage enhancement.

over 60 adenoma

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29
Q

how to tell adneoma on MRi

A

drop out on in and out phase imaging

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30
Q

what happens if the adenoma is functioning?

A

can gets cushings or conns

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31
Q

calcified adrenals - think….

A

prior trauma
infection like tb

tumour - melanoma mets, corticol carcinoma, neuroblastoma

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32
Q

Wolman disease

A

bilateral enlarged calcified adrenals

fat metabolism error, kills in 6 months

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33
Q

MEN 1

A

Parathyroid hyperplasia
pituitary adenoma
pancreatic tumour

straight line, number 1.

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34
Q

MEN2A

A

Medullary thyroid
Parathyroid hyperplasia
phaeo

A shape over the body.

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35
Q

Men 2B

A

Medullary thyroid cancer
phaeochromocytoma
Mucosal neuroma
Marfanoid body habitus

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36
Q

if renal echogenicity is greater than the liver what are we thinking

A

impaired renal function

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37
Q

Fetal lobulation vs scarring

A

lobulation - renal surface indentations overle the space inbetween the pyramids

scarring - indentations overlie the medullary pyramids

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38
Q

What is the dromedary hump?

A

focal bulge on left kidney, forms as a result of adaption to adjacent spleen

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39
Q

Column of bertin - what is it

A

splaying of the sinus due to hypertrophy of the cortical tissue in the middle.

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40
Q

BILATERAL kidney agensis should think about what syndrome ?

A

Potter sequence

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41
Q

uni;ateral kidney agenesis - what else to look for in men and women

A

Women - genital anomalies, unicornuate uterus

Men - 20% have absence of ipsilateral epididymis/vas deferens or seminal vesicale cyst

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42
Q

Potter sequence - what happens to result in no lungs

A

No kidneys
no pee
no development of the lungs

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43
Q

Mayer-Rokitansky-Kuster-Hauser

what is it

A

mullerian duct anomalies, including atresia of the uterus.

unilateral renal agenesisi is associated

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44
Q

Pankcake adrenal

A

elongated adrenal if agenesis of the kidney

useful for surgical or congenital absence of the kidney

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45
Q

Horseshow kidney, what is the ax

A

Wilms tumour
TCC from lots of infecitons
Recurrent infeciton

Turners syndrome

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46
Q

Crossed fused renal ectopia - what is it

A

one kidney comes over the midline to fuse with the other.

get infection, stones and hydronephrosis

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47
Q

RCC risk factors

A

tobacco
VHL
Dialysis chronic
Fhx

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48
Q

RCC in bones as mets appear as what

A

lytic

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49
Q

RCC with contrast

A

avidly enhance

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50
Q

can RCC have fat in them

A

for sure, often with calcification

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51
Q

subtypes of RCC

A

clear cell
papillary
medullary
chromophobe

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52
Q

clear cell RCC - ax with what
behaves with contrast on corticomedullary phase

A

Ax with VHL
equal to cortex on corticomedullary phase

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53
Q

papillary RCC - how vascular are they?

how will they enhacne

A

less vascular

less enhancement

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54
Q

medullary RCC is ax with what condition ?

A

Sickle Cell

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55
Q

Chromophobe RCC is ax with what?

A

Birt Hog Dube

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56
Q

How will renal lymphoma look liek?

A

can be anything
bilateral enalrged with lymph nodes around enalrged also

low attneuation corticol nodules/masses.

often get a preserved shape

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57
Q

renal leukaemia will look like what?

A

corticol based lesions

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58
Q

oncotyoma

benign or malignant

A

benign

second most common after AML

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59
Q

Oncotyoma looks like an RCC except for

A

A central scar

spoke wheel vascular pattern

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60
Q

RCC vs oncocytoma on PET

A

RCC is colder than parenchyma

Oncotyoma is hotter

butreally not used as reanlly excreted

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61
Q

non communicating, fluid filled loculs surrounded bby thick fibrous capsule protrudes into the renal pelvis

Dx
and distribution

A

Mutlilocular cystic nephroma

MJ lesion -bibodal distribution

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62
Q

Describe the 1st Bozniak cyst classifications

A

Simple - less than 15HU. no enhacnement

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63
Q

Describe 2 Bozniak cyst

A

Hyperdense, less than 3cm, thin calcification, thin septations

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64
Q

Bozniak 2F classification - what is it ?

A

hyperdense (over 3cm)
Minimally thickened calcifications

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65
Q

Bozniak 3 classifcaiton s

A

thick sepatations.
irregularnode

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66
Q

Bozniak 4 - classificaiton

A

any enhancement (<15 HU)
mural nodule

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67
Q

hyperdense cysts

A

greater than 70HU and homogenous considered benign.

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68
Q

ADPKD.
what happens to the kidneys

A

Get larger and lose function

get cyst in liver
Berry aneurysms

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69
Q

ARPKD what do they get?

A

hypertension and renal failure

abnormal bile ducts and fibrosis of liver

liver and kidneys are inversely related in how well the organs do

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70
Q

uraemic cystic kidney disease - who gets it?

A

end stage renal failure patients

cysts regress after transplant

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71
Q

VHL - what do people get ?

A

Pancreas - cysts and serous adenomas

Adrenal - phaeo

CNS - haemangioblastoma

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72
Q

How does Tuberous sclerosis affect the kidneys?

A

multiple bilateral angiomyolipomas

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73
Q

Renal cysts in lithium nephropathy - how many

A

inumerable tiny cysts

also small kidneys

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74
Q

Multicystic dysplastic kidney - who does it affect

what happens

A

kids in utero

no fucntioning renal tissue

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75
Q

on T2 - renal cysts are normally

A

bright

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76
Q

if renal cyst is T2 Dark what do you do?

A

Need to work between
Lipid poor AML (think TS)
Haemorrhagic cyst (T1 bright)
Papillary subtype RCC

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77
Q

common infection cuasing pyelonephritis

A

e coli

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78
Q

what is seen on pyelonephritis on CT/

A

perinephric fat stranding
striaited nephrogram

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79
Q

straited nephrogram is related to areas of decreased perfusion

what are the differentials?

A

Acute ureteral obstruction
acute pyelonephritis
medullary sponge kidney
acute renal vein thrombosis
radiation nephritis
renal contusion
hypotension
infantile polycystic kidney (bilateral)

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80
Q

emphysematous pyelonephritis

A

life threatening
necortizing

gas within the kidney or around

diabetics

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81
Q

emphysematous pyelitis

A

less bad to previous one

gas in collecting system

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82
Q

Pyonephrosis

A

infected or obstructed collecting system.

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83
Q

Xanthogranulomatous pyelonephritis

A

chronic destructive granulomatous process.

often staghorn as nidus for repeated infections.

Bear paw appearance

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84
Q

Papillary necorosis

A

renal papillae die - commonly involves medullary pyramids

Ax diabetes

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85
Q

causes of papillary necrosis?

A

pyelo, sickle cell, TB, analgesic, cirrhosis,

and the big one DIABETES

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86
Q

How does HIV nephropathy appear ?

A

echogenic on US
Loss of corticomedullary differentiation

Obliteration of sinus fat

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87
Q

types of kidney stone

A

calcium oxolate
struvite stone
uric acid
indinavir

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88
Q

commonest type of kidney stone

A

calcium oxolate

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89
Q

type of stone associate with UTI

A

struvite

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90
Q

Cystine associated with what

A

metabolic disorders

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91
Q

stones not seen on CT

A

Indinavir

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92
Q

what is corticol nephrocalcinosis?

A

happens as a result of corticol necrosis

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93
Q

what is medullary nephrocalcinosis ?

A

US hyperechoic renal papilla/pyramids.

cause commonest is hyper PTH

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94
Q

what is medullary sponge kidney

A

congenital
causes nephrocalcinosis.
Ehler danlos ax.
Beckwith weidman ax.

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95
Q

What is page kidney ?

A

long standing compression of the kidney by a SUBcapsular colleciton.

eg post lithotripsy sub capsular haemotoma.

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96
Q

what does it mean if there are persistent nephrogram?

A

shock / hypotension
causing ATN.

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97
Q

unilateral delayed nephrogram ?

A

pressure on the kidney some how.

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98
Q

what are the various signs in renal infarction ?

A

corticol rim sign(due to blood supply)

flip flop enhancement

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99
Q

when do you see the corticol rim sign?

A

immediately then 8hour to days later

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100
Q

renal vein thrombosis can mimic what what?

A

A renal stone
flank pain, swollen kidney and delayed nephrogram

101
Q

what does Renal vein thrombosis cause on doppler?

A

reversed arterial diastolic flow
absent venous flow

102
Q

How is renal trauma graded? what levels of injury?

A

haematoma

laceration <1cm

involvement of the vein or lac >1cm

collecting system lac, artery laceration

shattered kidney
avulsion of renal hilum

103
Q

What is meant by a fractured kidney?

A

laceration extending the full length of renal parenchyma

connects two corticol surfaces

104
Q

What is meant by a shattered kidney ?

A

3 or more fragments

105
Q

A segmental artery injury will appear as what kind of shape?

A

Wedge shaped perfusion defect

106
Q

A persistent nephrogram will raise concern for a

A

renal vein thrombosis / injury

107
Q

what kind of resitance should a transplant kidney have?

A

should always be low

108
Q

RI in transplant kidney should stay below what value?

A

0.7

109
Q

What will happen to the RI of a sick kidney

A

increase

110
Q

Complication categories of a transplanted kidney are what?

3 of them

A

Urologic

Vascular

Cancer

111
Q

Urologic complications of transplanted kidneys - what are they

A

Urinoma
haematoma
lymphocele
acute rejection / ATN
Chronic Rejection
Calculous disease

112
Q

Urologic complications of transplanted kidneys - Urinoma

details

A

within 2 weeks post op

Urine leak / urinoma

113
Q

Urologic complications of transplanted kidneys - haematoma

detial

A

Common immediately post op

114
Q

Urologic complications of transplanted kidneys

lymphocele

details

A

1-2 months post op. Leakage of lymph after surgery.

often between graft kidney and bladder

115
Q

Urologic complications of transplanted kidneys

acute rejection.

details

A

occurs in first week

RIs up, kidney enlarges
prominent pyramids

116
Q

to distinguish acute rejection from ATN

A

MAG3.
ATN has normal perfusion
Rejeciton abnormal perfusion

both delayed excretion

117
Q

Urologic complications of transplanted kidneys

chronic rejeciton

appearance

A

after 1 year

lose corticomedullary differentiation

118
Q

Urologic complications of transplanted kidneys

calculous disease

A

post transplant more likely to get these

119
Q

Vascular complications of transplanted kidneys:

what are they

A

renal artery thrombosis

renal artery stenosis

renal vein thrombosis

arteriovenous fistula

pseudoaneurysm

120
Q

Vascular complications of transplanted kidneys

Renal artery thrombosis occurs when

A

1% of transplanted kidneys within 1 week

121
Q

Vascular complications of transplanted kidneys

Renal artery thrombosis occurs because of

A

kinking
hypercoagulation
hyperacute rejection

122
Q

Vascular complications of transplanted kidneys

Renal artery stenosis

occurs in…

A

5-10% of patients

occurs at the anastomosis

there are specific criteria for this

123
Q

Vascular complications of transplanted kidneys

Renal artery stenosis

criteria on US

A

PSV >200-300cm/s

PSV ratio >3.0

Tardus parvus

anastomotic jetting

124
Q

Vascular complications of transplanted kidneys

Renal vein thrombosis occurs when

A

2nd week post op

125
Q

Vascular complications of transplanted kidneys

Renal vein thrombosis - doppler would show

A

in vein no flow

in artery reversed diastolic flow.

126
Q

Reverse M sign

A

doppler in renal vein thrombosis causes reversed diastolic blood flow in artery

127
Q

arteriovenous fistula

Vascular complications of transplanted kidneys

how do people get it

A

post biopsy - 20%
though most asymptomatic

128
Q

arteriovenous fistula

Vascular complications of transplanted kidneys

what will it show on US

A

pulsatile vein

tissue vibration artefact

129
Q

Vascular complications of transplanted kidneys

pseudoaneurysm

A

can get post biospy

yin yang color picture of doppler at the neck of the aneurysm

130
Q

what are the types of cancer i nthe post transplant kidney patient

A

RCC

Post transplant lymphproliferative disorder

cyclophosphamide can give urothelial cancer

131
Q

Cancer in the transplanted patient

RCC

A

normally occurs in native kidney

132
Q

Post transplant lymphoproliferativ disorder

A

Assocaited b cell proliferation

often involves multiple organs

linkto EB virus

133
Q

how many layers do the ureters have

A

3

134
Q

inner ureter layer is what

A

transitional epithelium

135
Q

Developmental Ureter anomalies

Congential primary MEGAureter

what is it

A

intrinsic dilation. not obstructed

almost always the left side only

136
Q

Developmental Ureter anomalies

Congential primary MEGAureter

what causes it

A

distal adynamic segment

reflux at the UVJ

idiopathic

137
Q

Developmental Ureter anomalies

Retrocaval ureter

what is it

A

developmental anomaly o the IVC
causes partial obstruction and recurrent UTI

Fishhook or reverse J appearance to the ureter

138
Q

Developmental Ureter anomalies

Dupicated system

what is the weigert meyer rule

A

Upper - Infer medially inserts, obstructs + ureterocele.

Low - flow –> reflux

up obstructs
low flows

139
Q

Developmental Ureter anomalies

ureterocele

what is it

A

cystic dilatation of the intravesicular ureter

secondary to obstruction at the ureteral orifice.

cobra head sign.

140
Q

Developmental Ureter anomalies

pseduouroeterocele

what is it

A

acquired dilatation of submucosla portion of distal ureter.

stone or bladder mlignancy possibe

loss of the usual lucent line cobra head sign

141
Q

Developmental Ureter anomalies

ectopic ureter

A

incontinence in women
inserts distal to the external sphincter in the vestibule

142
Q

Developmental Ureter anomalies

vesicouroteral reflux

what is it

A

retrograde flow of urine
short ureter as it corsses the bladder so dodgy valve mechanism .

143
Q

Developmental Ureter anomalies

congenital UPJ obstruction

A

20% are bilateral
defects in circular muscle bundle of the renal pelvis.

tx is pyeloplasty
ax with multicystic dysplastic kidney disease
crossing vessels.

Vesicoureteric reflux in opposite kidney

144
Q

ureteral wall calcificaitons

two dx to think of ?

A

TB

schistosomiasis

145
Q

ureteritis cystica

what is it

A

multiple small subepithelial fluid filled cysts in the wall
of the ureter.

diabetics with recurrent uti

146
Q

ureteral pseduo diverticolosis

what is it ?

A

from chronic inflammation

multiple small outpouchings in the upper middle thirds

147
Q

Leukoplakia

what is it?

A

premalignant squamous metaplasia

from chronic inflammation

148
Q

Malacoplakia

what is it

who does it affect

what happens

treatment?

A

inflmmatory condition in setting of chronic UTI

Ax E coli and immunocompromised women

nodular intramural lesions of ureter

can obstructs.

Michaelis Gutmann bodies.

improves with antibiotics

149
Q

causes of retroperitonealfibrosis

A

idiopathic 75% of the time

radiation
mediacionts (methyldopa, ergotamine, methysergie)

infalmmatory

malignancy (desmoplastic and lymphoma)

150
Q

imaging options in retroperitoneal fibrosis

A

PET to find a primary
RF - PET will be avid if inflammatory active

151
Q

which disorders are assocaited with Retroperitoneal fibrosis

A

Ig4

autoimmune pancreatitis
riedels thyroid
inflammatory pseudotumour

152
Q

subepitheliai lrenal pelvishaemtoma

what is it

aslsocalled a Antopol-Goldman lesion

A

thickened upper tract wall
patients on long term anticoag

mimic for TCC but doesn’t enhance post contrast

153
Q

Goblet and champgane glass sign think

A

TCC

154
Q

TCC risk factors

A

Drugs - cyclophosphamide
Occupation - dye workers

Stones
Horseshow kidney
ureteral psedodiverticulosis
hereditory non polyposis colon cancer

155
Q

Least likely place to get TCC

A

ureter

bladder most then renal pelvis

156
Q

Balkan nephropathy

A

super high rate of upper ureter TCC

degenerative nephropathy

causedby eating aristolochic acidd in seeds of the Aristolochia clematitis plant

157
Q

Schistomasis leads to

A

Squamous cell carcinoma

158
Q

Haematogenous metastasis

A

normally through soft tissues into the walls.

159
Q

What is a fibroepithelial polyp?

A

benign
proximal ureter

smooth oblong mobile defect on urography

160
Q

what cna cause medial deviation of the ureters

4 things

A

Retroperitoneal fibrosis
retrocaval ureter (right side)
pelvic lipomatosis
psoas hypertrohy

161
Q

What can cause lateral deviation of the ureters

A

retroperitoneal adneopathy
aortic aneurysm

psoas hypertrophy

162
Q

bladder developmental anomalies

prune belly (Eagle barrett)

A

malformation triad

abdo wall deficiency
hydroureteronephrosis
cryptoorchidism

163
Q

Bladder diverticula

seen in…
acquired due to…

A

boys
chronic outlet obstruction can cause

or ehlos dahnlos

164
Q

what is Hutch diverticulum

A

assocaited with reflux because of VUJ valves not working.

165
Q

where are bladder diverticula usually found

A

lateral walls or near ureteral orifices

ureters deviate medially adjacent to a diverticula

166
Q

bladder ears are what

A

transitory extrapeirooneal herniation of the bladder

protrudes bladder into the unguinal canal.

167
Q

Cloacal malformation

A

GU and GI drain together

168
Q

Urachus is what

A

the umbiliacl attachement of the bladder

can get pee in it

can get adneocarcinoma

169
Q

What are the types of bladder cancer

A

Rhabdomyosacoma

TCC

SCC

Adenocarcinoma of the bladder

Leimyoma

170
Q

Rhabdomyosarcoma

Botryoid variant produces a polypoid mass which looks like

A

a bunch of grapes

greekBotrys means grape

171
Q

Most common type of bladder TCC

A

superficial papillary 70-80%

in contrast to superfiicla high grade carcinoma in situ.

invasive.

superfiiclal - papillary or grade
invasive

172
Q

how does SCC show on imaging

A

heavily calcified bladder and distal ureters

173
Q

adenocarcinoma of the bladder ax with what

A

urachus

therefore midline

174
Q

post bladder diversion surgery

describe some early complications

A

Altered bowel function

urinary leakage

fistula

175
Q

Altered bowel function post bladder diversion surgery happens how

A

SBO or adynamic ileus

176
Q

fistula in bladder diverisonvsurgery is most common in which group o patients q

A

those who have received radiation

177
Q

describe some late complications of bladder diversion surgery

A

Urinary infection

Stones

Parastomal herniation

urinary stricture

tumor recurrence

178
Q

WHAT is emphysematous cystitis

A

gas forming organism in wall of bladder

diabetic

E Coli.

179
Q

How does TB in bladder presented

A

Calficiation
retracted bladder

will affect upper tracts before

180
Q

what are the three different types of fistula and their assocaited conditions

A

Colovesicial fistula
- Diverticular disease

Ileovesical fistula
- Crohns

Rectovesical fistulas
- Neoplasm or trauma

181
Q

neurogenic blader comes in what two forms/

A

small contracted bladder -above S2

atonic large bladder - motor or sensory

urine stases elads to complications

182
Q

stones in bladder can cause whatB?

A

irritation - risk factor for TCC and SCC

183
Q

Pear shaped bladder think

A

pelvic lipomatosis

haematoma

184
Q

key quesiton ot answer with bladder rupture

A

extra or intra peritoneal rupture

CT cystography to review

185
Q

Extraperitoneal bladder rupture

common with what fracture

A

pelvic

186
Q

Molar Tooth sign for blader rupture is what

A

contrast in the prevesicle space of Rezius.

187
Q

How does intraperiotneal bladder rupture happen

A

blow to a full bladder

blows the dome off

contrast around bowel loops

188
Q

Urethral trauma injuries are based on what ?

A

location

189
Q

what are the loctions of urethral injuries

A

Type 1 - stretched
T2 - rupture above UG diaphragm
T3 - belo UG diaphragm.
T4 - bladder extending to the urethra
T5 - injury to the anterior urethra.

190
Q

differentiate traumatic bulbar stricture vs gonococcal urethral stricture

A

long irregular stricture for gonococcal, in the distal

191
Q

urethrorectal fistula caused by

A

brachytherapy

192
Q

urethral diveticulum caused by placement of

A

long term foley catheter

193
Q

what kind of cancer will it be in. aurethral diverticulum

A

adenocarcinoma

194
Q

female urethral diverticulum is caused by

A

repeat infections of the periurethral glands

195
Q

how is a fractured penis defined

A

corpus cavernosum and its surround sheath the tunica albuginea

196
Q

Prostate
Central gland comprises

A

transition zone and central zone

197
Q

Prostate
Anterior fibromuscular gland on MRI

A

Dark on T1 and T2

198
Q

Central gland on MRI

A

brighter than the anterior fibromuscular gland

199
Q

Peripheral zone on T2 MRI

A

the brightest

200
Q

Prostate adenocarcinoma is found. inwhich zone

A

peripheral the most

then transition 20%
then Central zone 10%

201
Q

What does cancer do on T2 prostate

A

darkv

202
Q

cancer on MRI
diffusion does waht

A

restricts

203
Q

if prostate cancer restricts on MRI
what is the ADC

A

low

204
Q

Enhacnement and washout of prostate cancer on MRI

A

Type 3 curve

enhances and washes out

205
Q

prostate cancer stage b vs c

A

b - confined to the capsule

c - extension though. bulging of the capsule

206
Q

BPH involves which zone?

A

Transitional zone

median lobe indents bladder

207
Q

BPH nodules on MRI are

A

transitional zone
T2 heterogenous
restrict diffusion
enhance and washout

208
Q

post biopsy T1 bright in the gland

A

subacute blood

209
Q

prostatic utricle cyst / mullerian duct cyst

what are they

A

anatomical variant of caudal ends of mullerian ducts in men.

prostatic utricle is a focal dilationin the prostatic urethra.

210
Q

What conditions. areassociate with prostatic utricle cyst

A

Hypospadias
Prune belly syndrome, downs, unilateral renal agenesis, imperforate anus
large can get infected

211
Q

mullerian duct cyst can contains which cancers

A

endometrial
clear cell
squamous

212
Q

seminal vesicle cysts

A

unilateral, lateral cysts

congential or acquired

associated with
renal agensis, vas deferens agenesis, ectopic ureter insertion, PKD

213
Q

what are the midline male pelvic cysts

A

prostatic utricle -
urticlecyst - ax hypospadis
mullerian duct cyst - 30s 40s.
ejaculatory duct cysts

214
Q

lateral pelvic cysts in men

A

seminal vesicle cyst
diverticulosis of the ampulla of vas deferens

215
Q

testicle trauma

rupture vs fracture

why important

A

rupture need surgical intervention

216
Q

testicular rupture, what happens to the tunica albuginia

A

disrupted

217
Q

heterogenous testicle and poorly defined testicular outline think

A

Rupture testicle

218
Q

fracture testicle - aluginea layer

A

intact

219
Q

US appearance of testicle in a fracture

A

hypoechoic band across the testicle

220
Q

cause of torted testicle

A

Bellclapper deformity

abnormal high attachement of tunical vaginalis

increases mobility and predisposes to torsion
bilat so bilat orchiopexy

221
Q

epididymitis. caused by

A

chlamydia or gonorrhea

old men ecoli

222
Q

epidydymitis US findings

A

increased size and vascularity

can then go to orchid

223
Q

Isolated orchitis think….

A

mumps

224
Q

epidermoid cysts in testicle - what are they

A

benign
onion skin look.
non vascular

225
Q

calcified vas deferns in which patient group

A

diabetics

226
Q

hypodense leison ins testicle

A

cancer until proven otherwise

227
Q

absent doppler on hypoechoic testicular mass think

A

haematoma

228
Q

testicular mets via

except for

A

lymphatics

but choriocarcinoma is via blood

229
Q

testicle cancer risk factors

A

crypto orchidism
gonadal dysgenesis
klinefelters
trauma
orchitis

230
Q

What is recommended for testicular microlythisasis ?

A

6 month follow up

uncertain link wuth Germ Cell TUmours

231
Q

Seminoma appear as what

A

US - homogenous hypoechoic mass repalces entire testicle

MRI 0 homogenously T2 dark

232
Q

Non seminomatous germ cell tumour
types

A

mixed germ cell tumours
teratomas
yolk sac tumours
choriocarcinoma

heterogenous and larger calcificaitons

233
Q

Testicular lymphoma - why can it hide

A

blood testes barrier means difficult for chemo to get to. can hide

234
Q

Testicular lymphoma

what type

A

non hodkin B cell

235
Q

US appearance. oftesituclar lymphoma

A

focally or diffusely
hypoechoic vascular lymphomatous tissues

Multiople hypoechoic masses of the testicle

236
Q

Burned out testicular tumour

what is it

A

large dense calficiations of. anold tumour. May be active still. most take them out.

237
Q

which tumours get Gynecomastia

A

Sertoli Leydig Tumours

238
Q

Sertoli cell tumours also seen with

A

Peutz Jeghers

239
Q

Elevated hCG testicle tumours

A

Seminoma
Choriocarcinoma

240
Q

Elevated AFP testicle tumours

A

Mixed germ cell
yolk sac

241
Q

Casues of male infertility can be categorised as

A

Obstructive or Non obstructive

242
Q

OBstructive causes of male infertility

A

absent vas deferens (CF)
ejaculatory duct obstruction
prostatic cysts

Zinner syndrome

243
Q

Non obstructive cause of male infertility

A

variocele
cryptochidism
anabolic steroids
ED

244
Q

cryptorchidism is what

A

undescended testes

245
Q

cryptorchidism increased risk. of

A

cancer. inthat testicle
infertility
torsion
bowel incarcerated - ax indirect inguinal hernia

246
Q

Syndrome of cant smell and infertile

A

Kallmans

247
Q

Syndorme
tall gynecomastia
infertile

A

Klinefelters

248
Q

renal agenesis
ipsilateral vesicle cyst

syndrome

A

Zimmer syndrome

a Prometheus book FRCR Part 2A flashcards (9 decks)

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