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Renal 2020 > Radiology > Flashcards

Radiology Flashcards

1
Q

two modalities for visualising ureteric calculi

A
  1. KUB XR

2. non-contrast enhanced CT

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2
Q

which modality is first line for imaging ureteric calculi?

A

non-contrast enhanced CT

also shows complications and alternative diagnoses (appendicitis, hernia)

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3
Q

when should non-contrast enhanced CT be avoided for imaging ureteric calculi?

A

pregnant

young females

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4
Q

management of ureteric calculi

A

IM diclofenac

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5
Q

causes of macroscopic haematuria

A 
calculi
infection
tumour
trauma
clotting disorders
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6
Q

investigations in >50s for macroscopic haematuria

A
  1. CT urography

2. cystoscopy

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7
Q

describe CT urography

A

scan then add contrast which is excreted over 15 minutes

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8
Q

what does CT urography detect?

A

renal parenchyma and urothelial tumours

typically used for upper tracts

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9
Q

what does a cystoscopy examine?

A

bladder and urethra

allows ureteroscopy or ablation of tumours

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10
Q

why is investigations for macroscopic haematuria different if <50?

A

incidence of tumours is low so CT radiation unjustified

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11
Q

methods used to investigate macroscopic haematuria in <50s?

A

USS
cystoscopy
CTU

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12
Q

what does USS show?

A

calculi

renal parenchymal tumours

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13
Q

what can cystoscopy diagnose?

A

bladder TCC
bladder calculi
tumours
urethritis/prostatitis

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14
Q

when is CTU used in macroscopic haematuria of the <50s?

A

when other tests are norma

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15
Q

when is MR urography useful?

A

contrast allergy
renal impairment
pregnant

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16
Q

four phases of CT with contrast

A
  1. pre-contrast (best to depict calculi)
  2. corticomedullary
  3. nephrogenic
  4. excretory
17
Q

what is the corticomedullary phase of CT with contrast?

A

cortical enhancement 25-70 seconds after IV injection

18
Q

what is nephrogenic phase of CT with contrast?

A

80-180 seconds where the renal medulla enhances

19
Q

what is the excretory phase of CT with contrast?

A

5-15 minutes there is opacification of renal collecting systems

20
Q

what is the risk of using contrast in renal CT scan?

A

contrast-induced nephropathy (ATN)

21
Q

what is contrast-induced nephropathy?

A

impairment of renal function within 3 days of CT contrast

22
Q

management of contrast-induced nephropathy

A

follow hydration protocols (saline before and after using NaHCO3 rather than NaCl)

check renal function before CT

23
Q

imaging option in pre-renal impairment

A

MR angiography for RAS

24
Q

imaging in renal impairment

A

USS to guide biopsy

25
Q

imaging in post-renal impairment

A

USS to exclude hydronephrosis

may require CT

26
Q

imaging for painful scrotum or swelling

A

USS

27
Q

diagnosis of epidiymo-orchitis on USS

A

hypervascular

28
Q

testicular torsion diagnosis on USS

A

avascular

29
Q

what is hysterosalpingogram (HSG) used for?

A

infertility investigation into tubal patency

uterine anomalies

30
Q

two types of bladder rupture

A
  1. extraperitoneal (conservative management)

2. intraperitoneal (surgery)

31
Q

imaging modalities used for bladder rupture

A

cystography

CT cystography as contrast leaks through

32
Q

causes of urethral disruption

A

anterior pelvic fracture/dislocation

straddle injury

33
Q

management of urethral disruption

A

if suspicious DO NOT catheterise

34
Q

non-vascular interventional radiology

A

relief of obstruction (nephrostomy- catheter and stent)
drainage of abscess or cyst
biopsy of renal masses
guided ablation of renal tumours (RFA, cryoablation)

35
Q

vascular interventional radiology

A 
control bleeding (embolisation)
varicocoele embolisation
36
Q

risk to the kidneys when using MRI?

A

nephrogenic systemic fibrosis caused by exposure to gadolinium

37
Q

presentation of nephrogenic systemic fibrosis

A

skin erythema
pruritis
pain
can cause joint contractures, respiratory insufficiency and muscular atrophy

Renal 2020 (26 decks)

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