Radiology

Question 1

What are the types of imaging

Answer 1

Plain film
Intravenous urogram (IVU)
Ultrasound
CT
MRI Nuclear medicine

Question 2

First point of imaging call typically

Answer 2

X-ray
Cheap
Shows radio-opaque stones (calcium stone)

Question 3

Which stones don’t have calcium

Answer 3

Uric acid stones (gout)

Question 4

Where do ureters run on x-ray film and what is the significance of identifying them

Answer 4

Along line of transverse processes. This is where you look for ureteric calculus

Question 5

How does kidney stone patient present

Answer 5

Loin to groin pain
Restless
Haematuria
Oligouria

Question 6

What is USS useful for

Answer 6

Renal stones, renal obstruction, renal mass, bladder lesions. Cannot assess ureters

Question 7

For children what is the first imaging technique to use

Answer 7

USS- no radiation

Question 8

What are the problems with USS

Answer 8

Body habitus dependant. Cant assess ureters as can’t see through the air spaces present in gut.

Question 9

Benefits and limitations of MRI

Answer 9

Excellent for soft tissue
No radiation
Expensive
Long scan time 30-45min can’t use in someone who can’t stay still

Question 10

What is nuclear medicine

Answer 10

Whereby the patient takes radoopharmaceuticals and imaging can be done from inside out. e.g. PET scan. Useful for obstruction.

Question 11

What is micturating cystourethrogram

Answer 11

A scan assessing paediatric bladder function

Question 12

Patient presents with renal colic. No stones seen on Xray what should be the next investigation?

Answer 12

USS or CT depending on clinical story.

Question 13

What does stranding indicate

Answer 13

Inflammation, tissue damage. Suggests the epicentre of the problem.

Question 14

What is the cut off whereby you need surgical intervention to remove a stone in regards to size.

Answer 14

> 6mm

Question 15

Case- 42 year ol woman, right flank pain, fever, high WCC likely diagnosis? Imagine?Lab tests?

Answer 15

Pylonephritis

USS

Question 16

Case- 85 yo man recurrent UTI
Likely diagnosis?
Imaging?
Lab tests?

Answer 16

Enlarged prostate (tumour)
USS
PSA (lab)

Question 17

Case 22 yo woman with decreased renal function high urea and creatinine.
Likely diagnosis, imaging

Answer 17

Polycystic kidneys
Hereditary
USS

Question 18

25 yo man, crashed mountain bike
Clinical info?
Imaging?

Answer 18

Where trauma occurred?
Urinalysis?
Abdo exam. May still be soft if kidneys damaged as kidneys retroperitoneal.
USS- may not see free fluid as hidden. Need CT

Question 19

What is an angiomyolipoma

Answer 19

Angiomyolipomas are the most common benign tumour of the kidney and are composed of blood vessels, smooth muscle cells and fat cells.

Question 20

What is tuberous sclerosis

Answer 20

Rare disease whereby benign tumours grow throughout viscera. High death rate.

Question 21

To scan the female reproductive organs why is a full bladder necessary

Answer 21

Because you don’t get visuals through fat/air better through water.

Question 22

What are the first points of call for reproductive imaging and why?

Answer 22

USS and MRI to limit radiation to the gonads (CT)

Question 23

Mechanisms of prostate imaging

Answer 23

Trans-abdo
Trans rectal
MRI