Renal investigations Flashcards
Colic?
1 - XR KUB (only a minority visible - lacks sensitivity and specificity)
2 - CT KUB (definitive test)
Sites for stones to get stuck at?
Pelviureteric junction
Pelvic brim
Vesicoureteric junction
What should CT be avoided for stones and what is the alternative?
In pregnancy and if possible in young non-pregnant females
USS or MRI instead
When following up a small stone a few weeks later?
Simplest test that showed it the previous time, so if XR then do XR again
But if XR didn’t show it first time it won’t 2nd time
Investigation for macroscopic haematuria if over 50
CT urogram for - examines kidneys, collecting duct and tubules
Cystoscopy - examines bladder and urethra
What are the 2 scans in CTU most sensitive in detecting?
1st scan before contrast - calculi
2nd scan after contrast - renal parenchymal tumours and urothelial tumours of collecting duct/ureters
Investigations for macroscopic haematuria in those under 50?
USS to detect calculi/renal parenchymal tumours
Cystoscopy for bladder calculi/tumour or urethritis/prostatitis
CTU only when USS/Cystoscopy normal and macroscopic haematuria persists
What is used to characterise renal tumours?
CT
Renal mass containing fat?
angiomyolipoma
Renal mass containing fluid?
Cyst - solitary cysts are benign
Renal mass containing complex mix of solid areas and thick septa?
Malignant
Renal mass that is solid and larger than 3cm
Malignant
What is used to detect cause of pre renal AKI e.g. renal artery stenosis
MR angiography
What is used to detect intra-renal cause of AKI
US guided biopsy
What is used to detect cause of post-renal cause of AKI?
USS - hydronephrosis, how much the bladder empties,
Other things - CT
