Urinary Flashcards

Question

lipomatosis

Answer 1

- fat person w/ "incomplete bladder emptying" - overgrowth benign fat in pelvis (perirectal, per vesicular) - anterosup bladder displ. Pear/tear drop shaped.

Answer 2

- 2/3 local recurrence - looks bad=bad - deeper=bad * MC loc is actually the thigh

Answer 3

liposarcoma

Answer 4

1) anticoag 2) rupture/leaking aorta 3) bleeding RCC or AML (A's)

Answer 5

NHL-nodes larger, involve mesentery, non continuous | -HL nodes para-aortic early, more continuous

Answer 6

1) 0% 2) 0% 2F) <5% 3) 50% 4) 100% (ie: RCC)

Answer 7

- simple anechoic | - hairline thin wall

Answer 8

- hyper dense, <3 cm - thin Ca, sept - no ST

Answer 9

- hyperdense >3cm - minimally thickened Ca, wall or septa - no ST - totally intrarenal

Answer 10

- measureable enhancement | - thick/irreg or smooth wall/septa

Answer 11

same as 3 + distinct enhancing ST components

Answer 12

congenital hepatic fibrosis

Answer 13

- AML | - RCC (younger pts)

Answer 14

- cysts: kidneys, liver, seminal vesicle | - berry aneurysms

Answer 15

regress s/p tx

Answer 16

para (beside)-simple renal cysts that plunge into the renal sinus from the adjacent renal parenchyma. Org from parenchyma, may compress collecting system. look like cortical cyst but bulge in (instead of out) -peri-from renal sinus, mimic hydro

Answer 17

- acute ureteral obstruction - acute pyelonephritis - hypoTN (BL) - acute renal v thrombosis - renal contusion - radiation nephritis - medullary sponge kidney - infantile polycystic kidney (BL)

Answer 18

- thinning, atrophy, scarring | - HTr of normal residual tissue!

Answer 19

kid-Abx + nephrectomy

Answer 20

- kid-DM | - CS-women, DM, urinary obstruction

Answer 21

- US > CT (has trouble distinguishing pyonephrosis from hydronephrosis - F/F level

Answer 22

- DM (mc) - pyelonephritis - SCD (50% of SC pts dev PN!) - Tb - analgesia

Answer 23

- filling defects in calyx | - lobster claw-linear streek in calyx

Answer 24

-urinary tract

Answer 25

- earliest- pap necrosis/ "moth eaten calyces-deep cups/w-shaped central necrosis (pelvis remains symmetrical) - progressed necrosis --> cavity (MOST CHAR) - phantom calyx-focal stenosis of infundibulum - diffuse infundibulum stenosis--> caliectasis - ureteral stenosis --> Kerr kink-scarring of pelvis --> uplifted appearance at renal pelvis - putt kidney-Ca autonephrectomized end stage Tb kidney - Ca mesenteric nodes

Answer 26

- MCC renal fx in this population | - enlarged, echogenic, loss of fat (edema in fat)

Answer 27

punctate (cortical) Ca

Answer 28

- pre-existing renal dx (+DM w/ renal disease) - CHF - dehydration - myeloma

Answer 29

- Ca-oxalate-75% - struvite-women + UTI - uric acid-Unseen on xray - cystine-rare, cong disorders of metabolism - indinavir-HIV. only stone not seen on CT

Answer 30

- 5mm cut off | - uric acid-change acidic diet/mediacl (Kcitrate, NaBicarb)

Answer 31

- non-uric acid stones-higher HUat 80kEv | - UA-same at 80 and 140

Answer 32

disseminated PCP

Answer 33

- UL cystic dilation of CTs | - Ehlers-Danlos, Caroli's, BW

Answer 34

those with a capsule

Answer 35

perfusion of cortex (8hrs-days later) via dual bs

Answer 36

region of hypo density/hypoenh bc hyperdense on delayed

Answer 37

- nephrotic MC in adults - dehydration - indwelling umbilical venous catheter

Answer 38

(peak systolic-ED)/Peak Systolic

Answer 39

1) urologic-MC 2) vascular-2nd MC 3) cancer-3rd MC 4) AVN-steroids (- now w/ cyclosporine use) 5) trauma (more superficial, less rib protection)

Answer 40

- fluid collections - hyperacute rejection - acute rejection - ATN - cyclosporin toxicity - Chronic rejection

Answer 41

-transplant requiring dialysis in 1st wks. Amount of cold ischemia is best predictor

Answer 42

- hyperacute rejection-immediate, not imaged. - acute-swelling, RI+, MAG3 3pt crappy - ATN-MAG3 N perfusion w/ retained tracer - chronic rejection-same as acute - cyclosporin tox-ATN but months later

Answer 43

- MAG3 | * bx (despite Nucs)

Answer 44

- 100x at risk via immunosuppresion - nonmelanomatous skin cancer (annual skin exams), lymphoma, colon cancer - RCC-native kidney - PTLD-EBV, B cell proliferation, 1st yr, mult organs, mass encasing/replasing hilum. rx=(-) imm supp - urothelial-BK in donor kidney. cyclophosphamide

Answer 45

- fx-2+ fragms, lac goes full depth connecting 2 cortical surfs - shatter-3+ fragms

Answer 46

- segm a - devascularized - renal v thrombosis

Answer 47

- grades 1-3 conservative | - 4, 5-surgery

Answer 48

1) subcap hem 2) <1cm lac 3) >1cm lac, active bleed into perirenal space 4) fractured, blood outside perirenal space, segm infarcts 5) shattered, hilar injury, devasc

Answer 49

Tb | schisto

Answer 50

chronic inflamm (DM, recurr UTI) - tiny subep cysts - ?(+) risk cancer

Answer 51

small outpouching BL 75% -upper/middle 3rd -maligancy

Answer 52

chronic granulomatous condition--> ST nodularity/plaques in bladder and ureters (bladder MC) - imm supp F w/ chr UTI * E. Coli

Answer 53

malakoplakia

Answer 54

M-not mal | L-mal

Answer 55

squamous MP 2/2 chronic irritation - bladder > ureter - mural filling defects - risk SCC

Answer 56

- iso-75% - radiation, mx (methyldopa, ergotamine, methysergide), inflamm (pancreatitis, pyelonephritis, inflamm aneurysm), mal (desmoplastic rxn, Lymphoma) * mal=10% (PET to find 1˚?)

Answer 57

gallium+ | PET HOT in active phase

Answer 58

fibro-inflamm proliferation | -ass w/ IgG4

Answer 59

- Lat-RP LAD, aortic aneurysms, psoas HTr (proximal) | - med ("waisting")-RPF, retrocaval ureter, pelvic lipomatosis, psoas HTr (distal)

Answer 60

- long term anticoag - hemophilia - thickening upper tract wall w/o enh (vs TCC)

Answer 61

- smoking - azo - cyclophosph - aristolochic acid - horseshoe - stones - ureteral pseudodiverticulosis - hereditary non-polyposis colon cancer (II)

Answer 62

degenerative nephropathy endemic to Balkan States - high rate renal pelvis and upper ureter TCCs - 2/2 eating aristolocholic acid (AA) seeds in Aristolochia clematis plant

Answer 63

GI, Prostate, renal, breast

Answer 64

upper tract/pelvis - younger pt - smooth/oblong and mobile * vs tcc

Answer 65

- boys - chronic BOO - ehler danlos

Answer 66

-transitory extraperitoneal herniation of bladder into ing canal - in the infant, lies in a relatively high position in the pelvis and is proportionately large in relation to the abdominal cavity (1, 15). This position places the lateral base closer to the internal inguinal ring than in the adult. With increasing age, the bladder becomes almost completely a true pelvic structure except when distended (5). It is covered by peritoneum in its superior and posterior portions, while laterally and anteriorly it consists of only loose areolar tissue. * bladder ears: in young infants, NORMAL (?) protrusion of the lateral aspect of the bladder into the inguinal canal -vs diverticulum: herniation has smooth wall, wide neck

Answer 67

nodular and asymm

Answer 68

"hypovasc" but do enh (often arterial)

Answer 69

- recurr UTIs & stone dx - schisto - suprapubic cath

Answer 70

``` benign tumor (mc) at trigone -BW: unary hesitancy, drippling ```

Answer 71

- papillary (frond like, low grade) | - nonpapillary (aggressive)

Answer 72

- TCC-base (infest - squamous-trigone, lat - adeno-midline - rhabdo-paratesticular

Answer 73

- smoking - poison-arsenic, aniline, benzidine - diverticulu-2-10% via stasis. quick to spread (less m)

Answer 74

- bowel made into conduit or reservoir --> ureters att to it 1) incontinent 2) continent - compl: early (bowel function, leakage, fistula) & late (inf, stone, herniation, strictures, recurr)

Answer 75

1) bowel function-dynamic ileus (MC, 25%), SBO (3%, entero-entero) 2) urinary leakage-ureteral-reservoir anastomosis --> urinoma, 5% 3) fistula-mc in pts w/ pelvic radiation

Answer 76

- inf - stones - parastomal herniation-15% w/ ileal conduits. 10% need sx. obesity :( - urinary stricture- L>R (L is brought under mesentery) - recurr-adv org disease, 3-15%

Answer 77

- aunt minni | - removal of long-segm distal ureter --> stretch IL bladder toward short ureter and sew to psoas m

Answer 78

1) hematoma | 2) pelvic lipomatosis

Answer 79

- emphysematous-E coil, DM - Tb (from upper) - schisto-ENTIRE BLADDER will Ca

Answer 80

- colovesicular-diverticular - ileovesical-crohns - rectovesical-Neo or trauma

Answer 81

1) small contracted (pinecone/christmas tree)-spinal lesions above T12 2) atonic-sacral lesions and peripheral neuropathy 3) suprapontine lesions-spastic bladder w/ normal sphincters Sensory neurogenic bladder Inability to sense bladder fullness results in a large rounded and smooth bladder. Voiding is often preserved. Motor paralytic bladder Atonic large bladder with the inability of detrusor contraction during voiding. Uninhibited neurogenic bladder Rounded bladder with a trabeculated appearance to the mucosa above the trigone from detrusor contractions. On voiding large interureteric ridge is noted Reflex neurogenic bladder Results from detrusor hyperreflexia with a dyssynergic sphincter. This leads to contrast extension to the posterior urethra and an elongated pointed urthera with pseudodiverticula. Autonomous neurogenic bladder Intermediate between detrusor hyperreflexia (contracted) and dysreflexia (atonic).

Answer 82

1) drop from above 2) form 2/2 stasis * known RF for TCC and SCC

Answer 83

100% sensitive when filled w/ 300-400 mL

Answer 84

bladder rupture--> Cr abs by peritoneal lining--> elevation of blood Cr --> pseudo renal fx

Answer 85

- extra-molar tooth | - intra-bowel loops

Answer 86

``` pelvic fx (almost 100% -10% with pelvic fx have bladder rupture ```

Answer 87

- ant (penile, bulbous) | - pst (membranous, prostatic)

Answer 88

- FN: most ant portion of urethra - V: ovoid mound in pst prostatic urethra. - PU: center of V. embryologic mullein remnant

Answer 89

1) conus configuration | 2) inf margin obturator foramina

Answer 90

- ant: straddle | - pst-car accident

Answer 91

1) stretched, ie: in tact 2) membranous 3) membranous + bulbar- UGS ruptured, perineal/scrotal contrast. MC 4) bladder base --> prostatic urethra 5) bulbous

Answer 92

retrograde-ant part fills antegrade (voiding urethrogrphay)-pst pt fills -dynamic urethrography=using both

Answer 93

- bulbous trauma (MC)-short segm | - GN-long/irregular

Answer 94

- old form of surgery connecting pancr tx to bladder | - pancreatic enzymes jack up urethra --> extrav

Answer 95

small filling defects on RUG | -should not instrumentize (even RUG)-seeding

Answer 96

radiation (classically brachytherapy, 1%)

Answer 97

-long term foley

Answer 98

- rare - 80% SCC * prostatic urethra TCC 90% - diverticulum-adeno

Answer 99

- way more common than in men! - middle 1/3, pstlat wall - stress urinary incontinent (60%), UTI - BW=saddle bag - adeno

Answer 100

Antenatally, fetal kidneys show varying texture depending on gestational age. It is echogenic in the first trimester, with decreasing echogenicity as the pregnancy progresses. Corticomedullary differentiation can be appreciated after 15 weeks of gestation but clear demarcation between cortex and medulla can be seen at 20 weeks. Renal echogenicity decreases compared to liver and spleen after 17 weeks 12. Normal kidney appearance in adult: cortex is less echogenic than the liver medullary pyramids are slightly less echogenic than the cortex cortex thickness equals/is more than 6 mm 14 if the pyramids are difficult to differentiate, the parenchymal thickness can be measured instead and should be 15-20 mm 11 central renal sinus, consisting of the calyces, renal pelvis and fat, is more echogenic than the cortex renal pelvis may appear as a central slit of anechoic fluid at the hilum normal ureters are generally not well seen on ultrasound

Answer 101

- lymphoma - tcc - medullary cystic nephroma/medullary rcc

Answer 102

resection (indist from cystic rcc)

Answer 103

whipples testicular neo tb atypical mycobacterium

Answer 104

CL 3-5% | Bladder: 30-50%

Answer 105

reflux nephropathy

Answer 106

fat containing rcc

Answer 107

reflex nephropathy

Answer 108

shorter intramural course

Answer 109

-developing hypotension

Answer 110

UL-none | BL-100%

Answer 111

spastic detrusor against spastic sphincter

Answer 112

m invasive bladder cancer (rx=radical cystectomy s/p TURBT)

Answer 113

- Path: Benign renal tumor composed of eosinophilic epithelial cells arising from intercalated cells of collecting ducts - img: - Solid renal cortical mass lesion with central stellate scar - Encapsulated, well marginated, smooth contour - large mass with renal contour abnormality and compression of collecting system - lacks mal features - Ca/hem/necr rare - Degree and timing of enhancement are variable due to variable cellularity -CT: Isodense or slightly hyperdense relative to kidney ``` -MR T1WI Isointense to low signal T2WI Intermediate signal: Highly cellular components ↑ signal: Edematous stroma, central scar, cystic areas DWI ↑ signal in highly cellular components ↑ ADC values Not useful to differentiate from RCC T1WI C+ Dynamic postcontrast findings are similar to CECT ``` -Grayscale ultrasound Well-defined, homogeneous, hypo-/isoechoic mass Central scar: Usually echogenic Color Doppler Internal flow ± central radiating vessels

Answer 114

1) extraperitoneal- bladder protrudes through the inguinal ring, remaining entirely outside the peritoneum 2) paraperitoneal- also extraperitoneal protrusion with an adjacent peritoneal hernia 3) intraperitoneal, in which a more superior portion of the bladder carries its peritoneal covering into the inguinal ring *paraperitoneal type is twice as common as the intraperitoneal and that extraperitoneal hernias are rare

Urinary Flashcards

(149 cards)