Page 25 Flashcards
Type of papillary necrosis that presents with central erosion of the papilla?
medullary type (pag entire papilla, papillary type)
Hallmark of TCC
multiplicity and recurrence
Vesicoenteric fistula is almost always attributable to?
Crohn disease
Common causes of bladder wall calci
schisto, radiation, alkaline encrustation cystitis, tumor, TB, cytoxan cystitis, amyloidosis
What infective agent is tyically associated with ALKALINE ENCRUSTATION cystitis?
Proteus mirabilis
Conditions associated with malacoplakia
pulmonary TB, chronic osteomy, long-standing malignant disease elsewhere
Malignant bladder tumor associations
-SCC - bladder diverticulum, shistosomiasis
-adeno - exstrophy, cystitis glandularis, urachal remnants
Causes of teardrop/vertical bladder
hematoma, enlarged LN, pelvic lipomatosis, B external iliad artery aneurysms, IVC obstruction with collateral veins
Segmental failure of closure of the urachus at the bladder attachment?
urachocele / diverticulum in the dome of the bladder
Failure of closure at the umbilical attachment
umbilical sinus
What structure divides the male urethra into posterior and anterior portions?
inferior aspect of the urogenital diaphragm
What portion of the urethra is susceptible to straddle injury?
pars nuda (proximal 2 cm of the bulbous urethra, only portion of the anterior urethra that is not contained within the corpus spongiosum)
What divides the anterior urethra into bulbous and penile?
penoscrotal junction / suspensory ligament of the penis
Most dependent urethral segment?
bulbous
In retrograde urethrography, opacification of which glands/ducts is abnormal?
glands of Littre (chronic inflammation, stricture) and prostatic ducts (prostatitis, distal urethral stricture); normal - Cowper ducts and utricle
Classification of posterior urethral injury
-type 1 - contusion without imaging findings
-2 - stretch injury with elongation of the urethra without extravasation
-3 - partial disruption with extravasation of contrast agent from the urethra with opacification of the UB
-4 - complete disruption of the urethra w/o opacification of the UB and w/ urethral separation of <2 cm
-5 - same with type 4 but urethrap separation >2 cm
What anatomic anomaly is the absence of fixation of the testis by the leaves of the tunica vaginalis?
bell-clapper deformity
Narrowest segment
membranous
Other term for penile segment
pendulous
Which is more common, hypospadias or epispadias? Which is associated with bladder exstrophy?
hypo; epi
Intrascrotal twists associated with the bell-clapper deformity?
intravaginal torsion (extravaginal – if the twist of the spermatic cord is superior to the scrotum)
On which side are varicoceles more common?
left (left spermatic vein enters the renal vein at an acute angle)
Varicocele measurement
> 3 mm
(Brant) What is the US hallmark of Fournier gangrene?
gas in the scrotal wall and superficial tissues of the perineum
What serves as landmark for the lowest extent of the peritoneal cavity and for the
location of the ureteral junctions with the bladder?
seminal vesicles
How do you differentiate an ovarian mass from lymphadenopathy on CT?
Ovarian mass - ureters displaced posteriorly/posterolaterally. Lymphadenopathy - ureters displaced medially / anteromedially
Where is it best to evaluate uterine anatomy on MR?
T2
How do you differentiate bicornuate from septate uterus?
Bicornuate - with deep surface indentation at fundus, septate - thick muscular septum, only slight surface indentation
Interruption of Mullerian duct development resulting in congenital anomalies?
Arrested development, incomplete fusion, failure of resorption
Why is enhancement of leiomyomas variable?
Composed of variable amounts of fibrous tissue - less fibrotic, more enhancement
How do leiomyomas appear on MR?
Low on both T1 and T2, better seen on T2, inhomogeneous internal high T2 signal if with cystic degeneration
Criteria for extracapsular extension of tumor
- asymmetry of NV bundles
- tumor envelopment of NV bundle
- angulated contour of the prostate gland
- irregular, spiculated margins of the prostate
- obliteration of the rectoprostate angle
What are collision tumors?
coincident adenomas and mets in the same adrenal gland
