Witwer GUT Flashcards
Normal adrenal glands shape?
Note the normal Inverted Y or lambda shape of the Adrenal Gland
This disease releases large amts of catecholamines and causes these symptoms:
headaches, hypertension, tachycardia and diaphoresis (sweating)
Pheochromocytoma
60 YO MALE WITH HYPERTENSION AND HYPOKALEMIA should make you suspicious for what condition?
Conn Tumor causing primary hyperaldosteronism
These are symptoms of what?
fatigue, high blood pressure, and hypokalemia.
Conn Tumor causing primary hyperaldosteronism
Primary adrenal carcinoma is rare, but metastases to the adrenal gland are common, from common tumors, ie ______, ______, ______, ______
melanoma, lung, colon, breast.
In the peds population, two causes of VUR are?
1) Immature short ureteral tunnel which usually resolves with age,
2) Congenital anomaly at the Ureterovesical junction
What is the imaging for VUR?
VCUG or radionuclide cystogram
A lesion above the brainstem causes what?
- Involuntary bladder contractions
- Spincter relaxation
- Urge incontinence and a sudden, strong urge to urinate
A complete lesion of the spinal cord above T12 vertebral body causes what?
- Detrusor hyperreflexia and spastic external spincter (basically involuntary detrusor contractions)
- residual urine and reduced bladder capacity
A lesion to the spinal micturition reflex causes what?
- Loss of a sense of fullness
- Weak and unsustained contractions
- incomplete bladder emptying with large amts of residual urine
Treatment for hyperreflexive bladder
- Alpha blockers
- TURP
- botox
Treatment for areflexive bladder
- behavior mod to facilitate complete emptying
- Crede (push on bladder and lean forward when peeing)
- TURP
What to avoid in neurogenic bladder?
Try to avoid chronic indwelling catheters, infection.
what are the three main hold up places for a stone in the renal/ureter?
the ureteropelvic junction (UPJ), the ureterovesical junction (UVJ), and the crossover of the common iliac arteries.
Symptoms are severe pain in the back, flank, groin, or labia or scrotum.
Kidney stone
Imaging choice for kidney stone?
Non contrast spiral CT is the test of choice to evaluate for stone
Swelling of one or both kidneys. Kidney swelling happens when urine can’t drain from a kidney and builds up in the kidney as a result. This can occur from a blockage in the tubes that drain urine from the kidneys (ureters) or from an anatomical defect that doesn’t allow urine to drain properly.
Hydronephrosis
What can cause renal papillary necrosis?
Occurs with analgesic abuse (acetaminophen), pyelonephritis (infection of the kidney and pelvis), renal ischemia, diabetes mellitus, Sickle disease.
What are the two forms of nephrocalcinosis? Describe them
Cortical-acute cortical necrosis, posioning, prolonged hypercalcemia
Medullary- hyperparathyroidis
What can cause nephrocalcinosis?
Too much serum calcium
A congenital condition with dilated renal tubules. Usually asymptomatic but predisposes to infection and stone formation.
Medullary sponge kidney
Autosomal dominant condition with multiple cysts causing massive non-functioning kidneys. Seen with cysts in liver and pancreas. Renal failure usually occurs later in life, 40 to 50s. Relatively common.
Adult polycystic kidney disease
Rare finding, lower poles (bottom) of the kidneys are fused across the abdominal midline. Found incidentally but may have obstructions or stones as this patient has.
Horseshoe Kidney.
Treatment for atherosclerotic renal artery stenosis?
meds initially then balloon angioplasty
Treatment for fibromuscular renal artery stenosis?
balloon angioplasty
You can evaluate the bruit in renal artery stenosis by putting the stethoscope to the right and left of the _________ ____
Transpyloric plane.
This is Found in dehydrated patients or infants with clotting abnormalities.
Can cause nephrotic syndrome and blood clots to lung.
Renal vein thrombosis
Mc cause cystitis? (organism)
E. coli
Painless hematuria
renal cell carcinoma
Imaging for renal cell carcinoma?
CT, IVP, U/S
renal cell carcinoma can metastasize to which two places?
liver & heart
What type of cancer is Renal cell carcinoma?
Transitional cell
Called Transitional cell because the epithelial lining (urothelium) of the urinary system (bladder, ureter, and urethra) is called the transitional epithelium.
—-These tumors can be found in the ureters, bladder, urethra, and even kidney.
How do you find carcinoma of the prostate on imaging?
Transrectal US or MR shows asymmetry in gland.
Carcinoma of the prostate can predispose people to what?
Metastasize to the bones, bone pain, elevation of alkaline phosphatase
The testes form beneath the kidneys and embryologically descend through the inguinal canal and into the scrotum. They can get held up anywhere in between and also elsewhere. Thus, there can be _______, ie hidden testicles.
Cryptorchism
Fluid filling the Tunica vaginalis is termed a
hydrocele
Inflammation of the epididymis. Ultrasound to identify increased blood flow to the epididymis. Enlarged, heterogeneous, hyper-vascular findings of Epididymitis with reactive hydrocele.
Epididymitis
How to find Epididymitis?
U/s
What imaging is best to detect testicular torsion?
Ultrasound is the test of choice to evaluate by Doppler the blood flow to the testicle.
When the spermatic cord twists, torsion occurs. This is a painful condition.
testicular torsion
What is a Bell Clapper deformity?
where the Tunica vaginalis surrounds much of the testicle not only a portion. Torsion can cause death of the Testis and thus is an emergency.
T/F: Epididymitis/Orchitis have increased or blood flow except in inflammation
True
Testicular malignancy is Associated with ____ cells, ie sperm progenitors.
germ
What imaging can find a testicular malignancy?
U/S
How to detect a varicocele?
U/S
Varicocele is a varicosity of the ________ plexus
pampiniform plexus
Stein-Leventhal Syndrome
PCOS
Enlarged ovaries with thick sclerotic capsules and an abnormally high number of follicles
PCOS
Stein-Leventhal Syndrome is characterized by what symptoms?
obesity, amenorrhea, infertility, hirsutism and enlarged polycystic ovaries
One of the causes of lower abdominal pain in a woman of childbearing years.
Ovarian torsion
TOC for ovarian torsion?
U/S
an infection of a woman’s reproductive organs. It is a complication often caused by some STDs
Pelvic inflammatory disease
The walls of a Serous Cystadenoma of the Ovary are…
smooth and thin and without internal masses
Benign or malignant?
Cystadenoma
benign and can be large
the tissue within the uterine cavity that develops during the menstrual cycle. This tissue can sometimes be outside of the uterus, in the adnexa, even on bowel, then the condition is called endometriosis. This responds to the menstrual cycle and can be very painful.
endometriosis
This is endometrial tissue within the myometrium (myo-muscle, metrium-uterus). This is similar to but different than Endometriosis. It can be painful, cramping, uterine bleeding, dyspareunia (painful intercourse), infertility
Uterine Adenomyosis
Painless post-menopausal bleeding
endometrial CA
What type of CA is cancer of the cervix?
squamous
“frozen pelvis” on DRE
cancer of the cervix
