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5. URINARY > URINARY Section 11: Bladder > Flashcards

URINARY Section 11: Bladder Flashcards

1
Q
A

Prune Belly (Eagle Barrett Syndrome)

Shaped like a pear (big wide bell).

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2
Q

Prune Belly (Eagle Barrett Syndrome) Triad

A

Deficiency of abdominal musculature + Hydroureteronephrosis + Cryptorchidism (bladder distension interferes with testicular descent)

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3
Q

Midline mass + calcification in any urachal tissue =

A

Carcinoma

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4
Q

Priamary concern of Urachus

A

Development of a midline adenoCA

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5
Q

Bladder Diverticula can be acquired secondary to

A

Chronic outlet obstruction (Big prostate)

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6
Q

congenital bladder diverticula, seen at the vesicoureteric junction, NOT associated with posterior urethral valves or neurogenic bladder

A

“Hutch Diverticulum”

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7
Q
A

bilateral Hutch diverticula

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8
Q

Bladder diverticula associated syndrome

A

Ehlers Danlos Syndrome

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9
Q

Bladder Diverticula typically arise from

A

the lateral walls or near the ureteral orifices

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10
Q

Urachal diverticula

A

Anterior + Superior

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11
Q

Most Diverticula are

A

Acquired

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12
Q

Ureters deviate medially adjacent to a?

A

diverticula

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13
Q

“Transitory extraperitoneal herniation of the bladder”

A

Bladder Ears

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14
Q
A

Bladder Ears

This is not a diverticulum. Instead, it’s transient lateral protrusion of the bladder into the inguinal canal.

Smooth walls, and usually wide necks can help distinguish them from diverticula.

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15
Q

If the cquestion header specifically indicates “GROSS” hematuria =

A

Think bladder CA first

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16
Q

Gross hematura + > 50 y.o. = next step?

A

CT hematuria protocol / Urography (pre and post, with delays), cystoscopy

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17
Q
A

soft tissue in the bladder + focal wall thickening / nodules

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18
Q

diffuse circumferential bladder wall thickening =

A

Inflammation
infection
Chronic partial outlet obstruction if with enlarged prostate

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19
Q

most important phase for identifying bladder cancers

A

Delayed - white background of contrast makes soft tissue masses easier to see

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20
Q

This is the most common bladder cancer in humans less than 10 years of age.

A

Rhabdomyosarcoma

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21
Q

“Paratesticular Mass”

A

Rhabdomyosarcoma

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22
Q
A

Botryoid Rhabdomyosarcoma

“polypod mass, looks like a bunch of grapes”

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23
Q

most common TCC bladder subtype.

A

Superficial papillary

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24
Q

When I say Squamous Cell Bladder

A

you say Schistosomiasis

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25
Q
A

Squamous Cell Ca

“heavily calcified bladder and distal ureters (usually shown on plain film, but could also be on CT).

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26
Q

ongstanding Suprapubic catheter

A

Squamous Cell Ca

27
Q

When I say Adenocarcinoma of the Bladder,

A

you say Urachus

28
Q

associated with an increased risk of adenocarcinoma.

A

Bladder Exstrophy

29
Q

Most common benign bladder tumor

A

Leiomyoma (Bladder fibroid)

30
Q

“urinary hesitancy” or “dribbling” =

A

Leiomyoma

31
Q

This isn’t a bladder surgery but rather a surgical “complication” from a c-section.

A

Bladder flap hematoma

32
Q
A

Bladder flap hematoma

blood (hematoma) that drapes over the top and back of the bladder after a c-section performed with the common technique of a lower uterine incision.

33
Q

The general idea is that a piece of bowel is made into either a conduit or reservoir, and then the ureters are attached to it.

A

Diversion Surgery

34
Q

the most common early complication of diversion surgery

A

Adynamic ileus

35
Q

Early complications of Diversion Surgery

A

Alteration in bowel function
Urinary Leakage
Fistula

36
Q

Late complications (>30 days) of Diversion Surgery

A

Urinary infection
Stones
Parastomal Herniation
Urinary Stricture
Tumor recurrence

37
Q

Which side is the urinary stricture more common?

A

The left side, secondary to angulation

38
Q
A

Psoas Hitch

The “hitched” side has an upward projection towards the psoas muscle.

39
Q

This procedure is done in the situation where you have had an injury or pathology (stricture, cancer, etc…) involving a long segment of the distal ureter

A

Psoas Hitch

40
Q

stretch the ipsilateral portion of the bladder towards the short ureter and sew it (“hitch it”) to the psoas muscle.

A

Psoas Hitch

you stretched the bladder to bridge the gap.

41
Q

Why is psoas hitch done?

A

Used for people with long segment distal ureter injury / disease

42
Q

Gas forming organism in the wall of the bladder.

A

Emphysematous Cystitis

Common in diabetics

E. COli - most common

43
Q
A

Bladder tuberculosis

“thimble” bladder

calcifications might be present

44
Q
A

Bladder schistosoma = Squamous cell Ca

45
Q

Bladder fistula occurs in 3 conditions:

A
  1. Diverticulitis
  2. Crohns
  3. Cancer
46
Q

Colovesical fistula =

A

Diverticular disease

47
Q

Ileovesical fistula =

A

Crohns

48
Q

Rectovesical Fistula =

A

Neoplasm or Trauma

49
Q
A

Neurogenic bladder

“pine cone bladder”

trabeculated

50
Q

2 flavors of Neurogenic bladder

A

a. small contracted bladder

b. atonic large bladder

51
Q

acquired bladder diverticula is mainly from

A

Outlet obstruction (PGE)

Most common at the UVJ = stasis = bladder CA, stones and infection

52
Q

Bladder stones can be from

A
  1. from kidney
  2. develop secondary to stasis (outlet obstruction) or neurogenic bladder

RIsk factor for TCC and SCC

53
Q

“PearShapedBladder” is from

A
  1. Pelvic lipomatosis
  2. HEmatoma
54
Q

gold standard in bladder trauma

A

Cystography - Fluoro or CT

55
Q

Inadequate bladder distension in Cystography =

A

loss of sensitivity

56
Q

Cystography in bladder tauma - bladder must be distended with _ ml of diluted water soluble contrast

A

300-400 ml

57
Q

Best test for extra vs intra peritoneal ruptur in bladder trauma

A

CT cystography (cotntrast distending bladder) - 300-400 ml

58
Q

More common bladder ruprue

A

Extraperitoneal (89-90%) - pelvic fracture

59
Q

If there is a pelvic fracture, then the chance of a bladder rupture

A

10%

60
Q

If there is a bladder rupture, there is almost always a

A

pelvic fracture

61
Q
A

Bladder ruprue

“Molar tooh appearance”

Contrast from the Bladder filling the Prevesicle Space (Rezius)

62
Q

A direct blow to a full bladder, basically pops the balloon and blows the top off (bladder dome is the weakest part).

A

Intraperitoneal bladder rupture

the dude will have contrast outlining bowel loops and in the paracolic gutters. This requires surgery.

63
Q

“Pseudo Azotemia” (Pseudo Renal Failure) =

A

bladder rupture = creatinine absorbed via peritoneal lining = elevate creatinine = making it seem like the patient is in acute renla failure. kidneys are normal

5. URINARY (19 decks)

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