Urogenital (Yr 4)

Question 1

is the uterus and ovaries visible on radiography?

Answer 1

no - unless enlarged

Question 2

what makes it difficult to identify the uterus and ovaries on ultrasound?

Answer 2

hidden by the bladder and descending colon

Question 3

how does a pyometra appear on a radiograph?

Answer 3

dilated soft tissue opacity loops originating from between bladder and colon causing a mass effect

Question 4

where is the prostate usually found on radiograph?

Answer 4

soft tissue structure caudal to bladder and partly within the pelvic canal

Question 5

where does the urethra run in relation to the prostate?

Answer 5

centrally

Question 6

what are the three causes of prostatomegaly?

Answer 6

benign prostatic hyperplasia
prostatic neoplasia
prostatitis

Question 7

how do the causes of prostatomegaly vary when diagnosing?

Answer 7

benign prostatic hyperplasia - entire dogs, symmetrical enlargement, soft tissue opacity
neoplasia - castrated dogs, mineralised opacity, irregular shape
prostatitis - entire dogs, marked enlargement, regular/irregular, possible mineralisation

Question 8

what is the main differential for castrated dog with prostatomegaly and mineralisation?

Answer 8

neoplasia (will be asymmetrical and irregular)

Question 9

where do prostatic neoplasias usually mineralise to?

Answer 9

medial iliac lymph node

Question 10

can prostatitis cause mineralisation?

Answer 10

yes it is possible

Question 11

what are the three categories of contrast studies?

Answer 11

cystography
retrograde urethrography
IV urography

Question 12

what contract is used for cystography?

Answer 12

postive or negative contrast (not barium, can use air or iodinated contrast)

Question 13

what contrast is used for retrograde urethrography?

Answer 13

iodinated contrast

Question 14

what contrast is used for IV urography?

Answer 14

iodinated contrast

Question 15

how is cystography done?

Answer 15

catheterise and empty bladder
inject contrast medium until reasonably distended

Question 16

what is the best contrast study for looking at mucosal detail of the bladder?

Answer 16

double contrast (inject positive contrast and massage then do a pneumocystograph)

Question 17

how will calculi appear on double contrast cystography?

Answer 17

central defect in the contrast pool

Question 18

how will blood clots appear on double contrast cystography?

Answer 18

can be anywhere (central or adhered to wall)

Question 19

how will air bubbles appear on double contrast cystography?

Answer 19

at the pool margin (dependant) this is iatrogenic (an artefact)
they are very smooth well departed structures

Question 20

how is a retrograde urethrogram done?

Answer 20

catheterise and empty bladder then moderately inflate with air
place catheter at rip of penis/vulva and clamp
inject iodine contrast media and radiograph

Question 21

why should retrograde urethrograms be done under anaesthetic?

Answer 21

clipping the tip of penis/vulva before injecting contrast will be painful

Question 22

how is IV urography done?

Answer 22

IV injection of iodine and then monitor its transition to kidney, ureters and bladders through multiple radiographs

Question 23

what anatomical region is cystography good for?

Answer 23

bladder (calculi, massed, rupture, chronic cystitis)

Question 24

what anatomical region is a retrograde urethrogram used for?

Answer 24

urethra (bladder)

Question 25

what are indications for retrograde urethrograms?

Answer 25

stranguria, ectopic ureters

Question 26

what anatomical region is an IV urogram used for?

Answer 26

ureters and kidneys

Question 27

what colour is the bladder on ultrasound?

Answer 27

anechoic (black)

Question 28

what imaging is used to diagnose chronic cystitis?

Answer 28

double contrast cystography will show thickened irregular mucosa
(can also use ultrasound)

Question 29

what calculi can be seen as mineral opacities on radiography?

Answer 29

struvite
oxalate
calcium phospahate

Question 30

what calculi are non-opaque and can’t be seen on radiographs?

Answer 30

cystine
urate

Question 31

how can cystine and urate crystals be visualised?

Answer 31

double contrast cystography

Question 32

can bladder masses be visualised on radiography?

Answer 32

no because of effacement (soft tissue and fluid is the same opacity) so you need contrast or ultrasound

Question 33

where do bladder masses usually arise from?

Answer 33

trigone

Question 34

what imaging is used for suspected bladder rupture?

Answer 34

positive contrast cystography

Question 35

what is the only imaging that can be used to accurately assess the urethra?

Answer 35

retrograde urethrogram

Question 36

what are possible causes of irregular unilateral focal renomegaly?

Answer 36

neoplasia
cysts
abscess/haematoma

Question 37

what are possible causes of irregular bilateral focal renomegaly?

Answer 37

neoplasia
FIP
polycystic kidney disease

Question 38

what are possible causes of smooth unilateral generalised renomegaly?

Answer 38

neoplasia
hydronephrosis

Question 39

what are possible causes of smooth bilateral generalised renomegaly?

Answer 39

AKI
pyelonephritis
lymphoma
FIP

Question 40

what are the three causes of microrenale?

Answer 40

CKD
congenital dysplasia
atrophy

Question 41

what is the typical appearance of CKD kidneys on radiograph and ultrasound?

Answer 41

radiograph - small/irregular
ultrasound - poor corticomedullary definition, small, irregular

Question 42

what imaging is useful for visualising ureters?

Answer 42

IV urethrography