Urologic Imaging and Case Studies

Question 1

3 things high osmolality iodinated IV constarast is associated with

Answer 1

• hypervolemia
• CHF exacerbation
• Acute kidney injury

Question 2

A cystoscope uses ___ to distend the bladder, is inserted ___ and may contain instruments for ___ and ____

Answer 2

fluid, retrograde,biopsy, stone removal

Question 3

Best imaging study to demonstrate a renal calculus

Answer 3

Helical CT scan

Question 4

An intravenous pyelogram would be least effective for imaging….

Answer 4

…urethral stricture due to BPH

Question 5

A ureteroscope is beneficial to visualize…

Answer 5

….a constricture in the ureter

Question 6

An older male can be more difficult to perform cystoscopy on because of…

Answer 6

BPH curvature

Question 7

Hydronephrosis

Answer 7

Fluid distension of the kidney due to backing up of ureter blockage causing swelling

Question 8

IV radiographic contrast media used for IVP and CT scans

Answer 8

Iodinated derivatives utilized for opacification of the urinary tract by blocking x rays, injected via IV and filtered out thru kidneys, excreted by glomerular filtration and concentrated in urinary system

Question 9

High vs low osmolality contrast media (who is at risk?)

Answer 9

High osmolality contrast media causes fluid shifts in the body into the vasculature from the periphery (hypervolemia) putting certain patients at risk
Low osmolality is less concentrated and is more expensive but good for those with risk factors

Question 10

Contrast related renal dysfunction definition, what specific drug should you avoid giving a patient with this

Answer 10

-Iatrogenic acute renal insufficiency that causes AKI in hospitalized patients with underlying disease causing an increase in creatinine

Metformin because it can build up in blood

Question 11

Abdominal series plain films (3)

Answer 11

• Chest xray in case of referred pain from chest
• Flat plate (supine KUB)
• Upright film KUB

Question 12

CT scan definition and how to orient

Answer 12

Multiple plain films that form a computer cross section of 2D view thru the body, viewed as if from feet looking up to head where patients left side is on right side of image and patients right is on left side of image (bone is light and tissue is dark)

Question 13

MRI definition

Answer 13

A useful imaging study that does not involve radiation used to visualize soft tissue (tissue is light and bone is dark)

Question 14

Ultrasound definition

Answer 14

Painless, noninvasive, bedside, relatively inexpensive (bone appears white tissue appears dark)

Question 15

TRUS abbreviation

Answer 15

Transrectal ultrasound

Question 16

IVP procedure (4)

Answer 16

• First take a scout film KUB
• Inject IV contrast
• 1st scout film shows bones, soft tissue, and kidney stone if present
• 2nd film nephrogram phase shows contrast in renal parenchyma
• 3rd film excretion film shows contrast in ureters and bladder, no voiding cystogram!!!

Question 17

Retrograde Pyelography definition

Answer 17

Opposite of IVP, does not use IV contrast but uses water contrast introduced directly into ureters using cystoscope followed by KUB of abdomen, can be used to image the lower urinary system or if allergic to iv contrast or having renal failure

Question 18

Radionuclide imaging of kidney definition

Answer 18

Place a small amount of radioactive tracer into body via IV, then kidneys filtering blood flow filter it out, image with a gamma camera to see how well kidney filterrs out the tracer

Question 19

Renal arteriogram/angiogram definition

Answer 19

X ray image of arteries of kidneys using catheter introduced to renal artery and ocntrast injected, x ray then used to visualize renal vasculature

Question 20

Acute tubular necrosis is a __renal disease

Answer 20

pre