Urology Flashcards
Post radiotherpay, what type and where are strictures most likely to occur ?
Bulbous membranous portion of the urethra - just posterior to the apex of the prostate, causing a smooth long strcitures
what type of stricture does gonorrhea cause
long, irregular stricture of the distal bulbous urethra.
what scoring system is used for active surveillience of prostate cancer ?
PRECISE
what might granulomatous protatitis occur from ?
Post bladder cancer treatment with BCG
Post sarcoid or TB.
What does a DSMA scan look at
Static image, looking at morphology and structure. Used in paediatric imaging to look at the renal cortex
what type of study is a MAG3 study
Dynamic study, imaged every 2 mins for 20 minutes. excreted by the kidneys, so looks at renal function.
what is a catopril venogram looking for ?
renal artery stenosis.
what is a renal vascular pedicle injury?
tearing or occlusion of the renal artery or vein , usually secondary to a decelleration injruy
what is medullary sponge kidney?
the collecting ducts become dysplastic and dilated, leading to urinary status - causing the formation of calculi.
what are the two most common organisms that would cause xanthogranulomatous pyelonephritis ?
proteus mirabilis and e.coli
what is the treatment for xanthogranulomatous pyelonephritis ?
nephrectomy
what do patients with PCKD also usually have ?
hepatic cysts and saccular aneurysms
what is the difference in the type of cysts in recessive vs dominant PCKD ?
In recessive the cysts are small and innumerable.
Extra renally, what do patients usually develop in recessive PCKD ?
hepatic fibrosis
what may patients on lithium develop/
scattered uniform micro cysts
(the renal salts cause direct damage to the renal tubules, this results in progressive decline in renal function . This results in tubular atrophy, glomerulosclerosis, chronic interstitial nephritis, and distal tubular dilatation with microcyst formation)
which conditions predispose to RCC ?
Tuberus sclerosis
von hippel Lindau
Birt-hogg-dube
Hereditary papillary RCC
Sickel cell trait
Hereditary leiomyomatosis and rcc
what sign might indicate a renal AVM over a cancer?
Assymetrical enhancement of the renal vein due to shunting of venous blood
what is von hippel Lindau ?
AD multiorgan syndrome caused by mutation in the VHL tumour suppressor gene, results In cysts and neoplasms in multiple organs.
what is the primary renal manifestation of VHL?
bilateral, renal cell carcinoma - usually clear cell
what is the most common renal manifestation of Tuberus sclerosis ?
bilateral renal angiomyolipomas
what is the most common cardiac tumour in tuberus sclerosis?
rhabdomyoma
what lesions are seen in the lung in patients with tuberus sclerosis?
Lymphangioleiomyomatosis (LAM)
resulting in cystic replacement of lung parenchyma
what type of cancer is associated with sickle cell trait ?
medullary renal carcinoma
in children which drug might cause medullarycalcinosis
furosemide
what is the most common cancer of the ureter ?
TCC
what type of cancer usually affects the uracus ?
adneocarcinoma
which conditions are associated with medullary sponge kidney ?
beck-width wideman syndrome
carolis disease
ehlers-danlos syndrome
what are the causes of nephrocalcinosis
Hyperparathyroidism
medullary sponge kidney
Renal tubular acidosis
renal papillary necrosis
sarcoidosis
What type of cancer is associated with bladder leukoplakia ?
Squamous cell carcinoma
what are some primary causes of ureteropelvic junction obstruction?
congenital peristaltic segment of ureter
High insertion of the ureter on the renal pelvis
crossing of vessels causing extrinsic compression
what is a ureterocele ?
focal dilatation of the distal ureter which protrudes into the bladder
what is an ectopic ureterocele ?
associated with duplication collection system - where the ectopic insertion to he upper pole ureter into the bladder
what is a pseudoureterocele ?
intersusseption of the distal ureter into the bladder - usually due to radiation, tumour, or stone
what is an orthotic ureterocele?
normally inserting ureter
what type of bladder cancer is assoicated with a urachal remnant ?
adenocarcinoma
where do gonoccoal infection strictures tend to occur in the urethra ?
bulbous
where do straddle injures cause strictures in the urethra ?
bulbous urethrea
what condition is seen with bilateral seminal vesicle genesis ?
cystic fibrosis
post prostate biopsy - will normal or cancerous tissue be T1 hyperintesne ?
normal tissue will be t1 hyperintense due to citrate production which causes bleeding. Cancer tissue doesn’t produce citrate and therefore doesn’t bleed - known as the haemorrhage exclusion sign
what assessment score is used in MRI for prostate cancer ?
PI-RADS
which testitcular tumour will have a rise in AFP ?
embryonal tumours or yolk sac tumours in pads
which testitcular tumour will have a raised HCG ?
Chroicarcinoma
Where to testicular choriocarcinoma metastasis too ?
lungs and brain
what are the most common metastasis to the testicles ?
leukaemia and lymphoma
what is the most common type of testicular tumour ?
seminoma
what is a burnt out germ cell tumour /
where the testicular tumour has outlived its blood supply and regressed, however there are metastasis seen usually retroperitonel
what will a testicular epidermoid cyst look like and what is the treatment ?
alternative onion skin appearance. usually treated with local excision rather than orchidectomyu
what extra-testicular symptoms might a leydig cell tumour of the testicle present with ?
gynaecomastia
what is the lymphatic draining of the superior third of the vagina ?
external iliac nodes
what is the lymphatic drainage of the middle 3rd of the vagina ?
internal iliac and sacral nodes
what is the lymphatic drainage of the Lower 3rd of the vagina ?
superficail inguinal nodes
where doe the skene ducts lie ?
next to the opening of the urethra
where do the bartholin gland cysts lie ?
next to the opening of the vagina
is the endometrial tissue in adenomyosis functioning or non-functioning
non-functioning
on MRI what would a adenomyosis look like ?
diffuse thickening of the junctional zone >12mm often with multiple small T2 hyper intense foci
what is a lipoleiomyoma ?
a fat containing fibroid in the uterus
what might you see on US for an ovarian torsion ?
> 4cm
Peripherally based cysts
low flow to the ovary - ?necrosis
what is Meigns syndrome
triad of benign ovarian fibroma, ascites and right pleural effusion
(Ovarian fibromas look like uterine fibromas - so have spindle cells which look chalky on cutting)
what is the most common histological subtype of an ovarian tumour ?
surface epithelial tumours
what is the classic ultrasound appearance of a dermoid cyst ?
rokitnasky nodule
what is the definition of a teratoma
Contains all three primitive layers
what MRI sequence will help determine between a teratoma and an endometrioma
fat suppression - loss of signal on the teratoma w
what is a krukenberg tumour ?
ovarian metastasis of a mucin-producing tumour usually gastric or colon adenocarcinoma
What are serous cysadeocarcinomas of the ovaries usually like ?
bilateral, mixed solid and cystic mass. the solid component will be avidly enhancing. usually ascites
what are mutinous cystadenocarcinomas of the ovaries usually like ?
large, unilateral tumours in older people. mucin right T1 fluid
in a pre-menopausal women , what size of ovarian cyst needs follow up ?
> 7cm
in a post-menopausal women what size of ovarian cyst needs follow up ?
> 5cm
what causes a follicular cyst ?
failed ovulation of the dominant follicle
what causes a corpus luteal cyst ?
failure of involution of the corpus luteum
what causes theca lutein cysts ?
raised HCG - so seen in trohoblastic pregnancy - such as molar pregnancies
what is the blood supply to the ovary ?
dual blood supply ; ovarian artery from the aorta - lateral and the uterine artery from the internal iliac artery - medial
what syndrome is adenoma malignum of the cervix associated with ?
peutz-jeghers syndrome
what size of cervical mass should be investigated with an MRI ?
> 1.5cm
what makes a cervical cancer in-operatble ?
if it extends into the cervical storm
what is a DES uterus at increased risk of ?
clear cell vaginal cancer
what might you see with adenomyomatosis on MRI ?
junctional zone > 12mm
what is the criteria for diagnosing ovarian hyper stimulation syndrome ?
symmetrical spoke wheel enlargement of the ovaries >5cm and presence of ascites or hydrothorax.
what is the triad associated with birt-hogg-dubbe
basal lung cysts, cutaenous lesiosn and renal cysts/cancer
what is testicular microlithasis associated with ?
testicular germ cell tumour
what testicualr lesions have an onion appearance with multiple rings of hyper and hypo echoic layers ?
epidermoid cysts
which cancers metsastes to the testies ?
prostate
lung
kidney
where do people with von-hippel Linda commonly develop cysts ?
kidneys, pancreas and GI tract
