Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Uro Radiology (Basics) > Renal Basics > Flashcards

Renal Basics Flashcards

1
Q

What are the different Bosniak Classifications for renal cysts?

A 
1
2
2F
3
4
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the CT finding and management of Bosniak 1 cyst

A

CT finding: Simple cyst (HU 0-20, simple fluid), thin wall, no septa or calcification

  • ~0% risk malignancy
  • no surveillance unless symptomatic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the CT finding and management of Bosniak 2 cyst

A

CT finding: Thin septa, fine calcifications, < 3 cm, hyperdense

  • very low risk malignancy (< 3%)
  • No surveillance unless symptomatic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the CT finding and management of Bosniak 2F cyst

A

CT finding: Endophytic, > 3cm, multiple thin septations and calcifications

  • ~5-10% malignant
  • Periodic surveillance (CT, MRI, or US)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the CT finding and management of Bosniak 3 cyst

A

CT finding: Thick or irregular septations or walls, increased calcifications, may enhance with contrast

  • ~50% malignant!
  • surgical excision
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the CT finding and management of Bosniak 4 cyst

A

CT finding: Thick walls, nodularity, marked heterogeneity and calcifications, enhances with contrast

  • 75-90% malignant
  • surgical excision
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Which Bosniak classifications lack contrast enhancement?

A

Category 1 to 2F lack contrast enhancement; 3 and 4 enhance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Difference between ADPKD and ARPKD?

A

ADPKD: presents in adults

ARPRK: presents in kids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Polycystic kidney disease presents how?

A

Innumerable, bilateral renal cortical cysts and hepatic cysts; associated with Berry aneurysms on brain imaging

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

CT imaging in a kid shows renal medullary cysts formed at the corticomedullary junction. Dx?

A

Nephronophthisis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the MCC of genetic ESRD in kids?

A

Nephronopthisis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

CT scans are the most sensitive study to detect nephrolithiasis, except for which type of stone?

A

Indinavir calculi (protease inhibitor for HIV)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Does MRI visualize calculi well?

A

No

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Which stones are radiopaque? (Hint: name 4)

A

Calcium oxalate, magnesium ammonium phosphate (struvite), calcium phosphate, and cystine (poorly opaque)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Which stone are radiolucent? (Hint: name 5)

A

Indinavir stones, uric acid, xanthine, ammonium urate, and matrix stones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Renally derived calcifications that are found in the renal parenchyma are called?

Etiologies?

A

Nephrocalcinosis

Medullary sponge kidney, hyper-PTH, type 1/Distal RTA, TB, papillary necrosis, hyperoxaluria

17
Q

Name 3 common developmental renal pseudotumors. What imaging study best distinguishes them?

A
  1. Dromedary hump
  2. Hypertrophied Column of Bertin
  3. Persistent Fetal Lobulation

DMSA scan (remember, it binds the proximal tubules, highlighting the renal cortex)

18
Q

DMSA or US scan shows a left renal contour variant with a single bulge on the lateral renal border. Dx?

A

Dromedary hump

- caused by splenic impression on superolateral border

19
Q

Imaging shows normal renal variant with enlargement of the cortex between the renal pyramids. Dx?

A

Hypertrophied Column of Bertin

-

20
Q

Imaging shows renal contour indentations in between the renal pyramids. Dx?

A

Persistent fetal lobulations

  • due to incomplete renal lobule fusion during fetal development
  • vs. renal scarring where the indentions are OVER the renal pyramids
21
Q

At what HU’s should you suspect renal cell carcinoma?

A

All enhancing masses > 20 HU’s are cancer til proven otherwise

22
Q

What imaging study can help delineate renal vein/IVC involvement of tumor?

A

MRI scan with T2-weighted signal intensities

  • Hyperintense = Clear cell RCC (water filled cells!)
  • Hypointense = Papillary RCC
23
Q

In women with enhancing renal mass(es), what additional study should be performed?

A

Mammogram to r/o breast cancer metastasis

24
Q

All patients should get what additional imaging if an enhancing renal mass is found?

A

Chest X-ray (or chest CT if CXR in inconclusive)

Get brain CT if neurologic signs/symptoms present

25
Q

You should get a bone scan if what laboratory marker is elevated in someone with an enhancing renal mass?

A

Alkaline phosphatase

26
Q

Enhanced imaging or angiography showes a renal tumor with a “spoke wheel pattern.” Most likely dx?

A

Oncocytoma
- 1/3 of tumors show a “central stellate scar”; however, RCC’s can have these central scars as well (one reason why renal biopsy is sometimes indeterminate)

27
Q

Angiomyolipoma on a CT scan looks how?

On an US?

A

Negative HU’s (i.e. fat) within a renal mass

  • calcifications present, consider it to be carcinoma
  • beware Epithelioid variant, which has a paucity of fat

On US, appears as an echogenic mass which produces a “speed propagation artifact” (sound waves slow in fat, making posterior objects appear further in the distant
- pathognomonic: Echogenic mass with no shadowing

28
Q

This is a benign congenital disorder with multiple cysts in the collecting ducts, nephrocalcinosis, and “paint brush-like calyces”

A

Medullary sponge kidney

- paint brush-like = bright white calyx (handle) with the pyramid (brush)

29
Q

CT with contrast shows a focal wedge defect with reduced enhancement, including the rim. Dx?

A

Pyelonephritis

30
Q

CT shows decompressed renal pelvis with dilated calyces, parenchymal enhancement, and staghorn calculus. Contrast study or renal nuclear scan shows poor renal function. Dx?

A

Xanthogranulomatous pyelonephritis

  • can be confused with RCC
  • massive caliectasis without pelviectasis is called the “Bears paw sign”
31
Q

What are some renal buzzwords/findings and their descriptions for GU Tuberculosis? (Hint: name 3)

A
  1. Moth-eaten calyx: calyceal erosion and necrosis (earliest sign)
  2. Infundibular stricture and parenchymal calcifications
    - stricture can cause “phantom calyx” or local caliectasis
  3. Putty kidney: caseous necrosis, radiopaque material seen in end-stage renal TB
32
Q

What ureteral image findings do you see with GU TB?

A

“Sawtooth ureter”: mucosal ulcerations and irregularities/beading

  • sometimes called corkscrew ureter
  • strictures most common distally
33
Q

What GU TB findings do you see in the bladder?

A

“Thimble bladder:” thickening of bladder wall with reduced capacity

34
Q

What CT findings are associated with a renal infarct?

A

Focal wedge defect with reduced enhancement, but the rim of the cortex may enhance due to collateral blood supply (cortical rim sign)
- cortical rim sign present ~50% of cases, seen hours to days after infarct

35
Q

What CT findings are associated with severe renal disease?

What size cut-off is generally ominous for end-stage kidneys?

A

Diffuse increased echogenicity bilaterally, loss of corticomedullary differentiation, and renal atrophy

Size of < 9 cm = ESRD, best measured with US

Uro Radiology (Basics) (13 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions