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54 Cards in this Set

  • Front
  • Back
Renal mass lesions
tumor – solid, cysts; infection – lobar nephronia, abscess, XGP; congenital – duplicated collecting system; pseudotumors – fetal lobulation, dromedary hump, column of Bertin; trauma - hematoma
Solid renal neoplasm
RCC, oncocytoma, adenoma, AML, TCC, mets (lung, colon, melanoma, RCC), lymphoma, Wilms, mesoblastic nephroma, nephroblastomatosis, MFH
Cystic renal masses
tumor – cystic RCC, multilocular cystic nephroma, cystic Wilm’s, cystic mets; true cysts – cortical cysts, localized cystic disease, medullary cystic disease, ADPKD, VHL, TS, endstage renal failure, hemorrhagic or infected cyst; other – hydronephrosis/duplicated system, renal artery aneurysm, abscess
Hyperechoic renal mass
AML, RCC, milk of calcium cyst, nephritis (XGP, emphysematous pyelonephritis, focal nephritis, Candida), hematoma, infarction, mimics (renal sinus fat, duplicated collecting system)
Renal sinus mass
TCC, RCC, lymphoma, papilloma, renal artery aneurysm, renal sinus hemorrhage, complicated parapelvic cyst
Wedge-shaped renal lesion
renal mets, infarction, lobar nephritis
TCC, mets, lymphoma, infarction, pyelonephritis, XGP
Diffusely hyperechoic kidneys
glomerulonephritis, DM, HTN, AIDS nephropathy, SLE, vasculitis, ATN, HUS, multiple myeloma, endstage renal failure, medullary or cortical nephrocalcinosis, ARPKD
Renal calcifications
tumors – cysts, RCC; infection – TB; metastatic calcification – medullary nephrocalcinosis, cortical nephrocalcinosis; collecting system – calculi
Fat in kidney
AML, lipoma, replacement lipomatosis
Hypoechoic perirenal fat
normal variant, perirenal hemorrhage, cyst rupture, SLE, PAN
Filling defect in collecting system
tumor – TCC, papilloma, leukoplakia, malakoplakia; mobile filling defect – blood clot, sloughed papillae, calculus, fungus ball; other – vascular impression, overlying bowel gas
Papillary necrosis
POSTCARD – pyelonephritis, obstruction, sickle cell, TB, cirrhosis, analgesics, RVT, DM
Delayed (persistent) nephrogram
prerenal – RAS, hypotension; renal – acute glomerulonephritis, ATN (contrast, ischemia, transplants), acute cortical necrosis (pregnancy, sepsis, dehydration), tubular precipitation (uric acid, hemolysis, myeloma), acute interstitial nephritis (antibiotics), papillary necrosis, RVT; postrenal – obstruction (stone, stricture); rule of thumb – symmetric bilateral is medical disease, asymmetric unilateral is surgical
Striated nephrogram
acute pyelonephritis, renal contusion, RVT, ureteral obstruction, medullary sponge kidney
Large kidney with spindled calices
lymphoma, leukemia, pyelonephritis, acute RA occlusion, acute RVT, acute obstruction
Normal size kidney with spindled calices
multiple cysts (parapelvic or peripelvic), renal sinus lipomatosis
Hypodense rim
acute cortical necrosis, perinephric lymphoma
Subcapsular rim sign
infarct, ATN, RVT
Extracalyceal contrast
striations – medullary sponge kidney, early papillary necrosis, pyelosinus or pyelovenous backflow in obstruction, interstitial edema; focal collections – late papillary necrosis, calyceal diverticulum, cavity from cyst rupture, abscess
Dilated calyces/collecting system
obstruction, papillary necrosis, congenital megacalyces, calyceal diverticulum, reflux
Bilaterally enlarged kidneys
ADPKD, lymphoma, glomerulonephritis, HIV, amyloid, bilateral RVT
Bilaterally small kidneys
chronic inflammation, bilateral RAS, chronic reflux, ESRD
Unilateral renal atrophy (smooth)
chronic ischemia (RAS, RVT), postobstructive atrophy, renal hypoplasia, chronic subcapsular hematoma, radiation
Unilateral renal atrophy (irregular)
reflux nephropathy, analgesic nephropathy, DM
Renal TB
parenchymal calcs, putty kidney, papillary necrosis, tuberculoma, scarring, mucosal irregularity, infundibular stenosis, amputated calyx, corkscrew ureter, purse-string stenosis of renal pelvis, pipestem ureter, calculi, small contracted thick-walled bladder, urethral fistulas (watering can perineum)
parathyroid adenoma or hyperplasia, Addison disease, milk alkali, sarcoid, carcinomatosis, HPT, myeloma, immobilization, vitD, thiazides
Cortical nephrocalcinosis
chronic glomerulonephritis, cortical necrosis (pregnancy, shock, sepsis, toxins), AIDS nephropathy, Alport’s, oxalosis, chronic transplant rejection
Medullary nephrocalcinosis
HPT, RTA, medullary sponge kidney, papillary necrosis, Lasix therapy in kids
Renal vein thrombosis
tumor - RCC, Wilm’s, lymphoma, TCC, adrenal, gonadal, pancreatic CA, extraluminal compression by retroperitoneal tumor; renal disease – membranous glomerulonephritis, SLE, amyloid; other – hypercoagulable state, extension of ovarian vein or IVC thrombosis, trauma, surgery, transplant complication, dehydration in kids
Dilated ureter
criteria - >8mm, ureter visible in entire length, no peristaltic waves; obstruction – primary megaureter (functional), ureteral stricture, calculus, BOO, urethral stricture; reflux; diuresis
Ureteral stricture
tumor – TCC, mets, lymphadenopathy; inflammatory – TB (corkscrew appearance), Schistosomiasis, Crohn’s, PID; congenital – ectopic ureterocele, primary megaureter, congenital stenosis; metabolic, drugs – amyloid, morphine, methysergide (retroperitoneal fibrosis); trauma – iatrogenic, radiation; vascular – aneurysm, ovarian vein syndrome, lymphocele, crossing vessel
Multiple ureteral filling defects
wall – ureteritis cystica (more common in upper ureter), vascular impressions, multiple papillomas, melanoma mets, submucosal hemorrhage, fibroepithelial polyp (single); luminal (acute angles) – calculi, blood clot, sloughed papillae, fungus ball, air bubbles, TCC
Ureteral diverticula
congenital, pseudodiverticulosis, TB (also strictures)
Deviated ureters
lateral – bulky RP adenopathy, primary RP tumors, RP fluid collection, aneurysm, malrotated kidney, ovarian or uterine mass; medial – posterior bladder diverticulum (#1 cause of distal medial deviation), fibroids, RP fibrosis, postoperative, enlarged prostate, retrocaval ureter (only on R side)
Bladder wall thickening
criteria - >5mm, trabeculations; tumor – TCC, lymphoma; inflammation – radiation, cytoxan, infection, IBD, appendicitis, diverticulitis; BOO – BPH, PUV, ectopic ureterocele, urethral stricture; neurogenic
Bladder filling defect
tumor – TCC, SCC, mets, leiomyoma, endometriosis, polyps; infection – PID, Schistosomiasis, fungus ball, leukoplakia, malacoplakia, cystitis cystica, cystitis glandularis; luminal – calculi, blood clot, BPH, foreign body, ureterocele, pseudoureterocele; adjacent inflammatory process e.g. appendicitis or divertiticulitis; rare – amyloid
Bladder neoplasm
TCC, SCC, adenocarcinoma, leiomyoma, pheochromocytoma, mets (melanoma, prostate), lymphoma, urachal adenoCA (dome); risk factors
Bladder wall calcification
SCRITT – Schistosomiasis, cytoxan, radiation, interstitial cystitis, TB, TCC
Air in bladder
instrumentation, catheter, bladder fistula (diverticulitis, Crohn’s, colon CA), emphysematous cystitis (DM)
Teardrop bladder
normal variant, iliopsoas hypertrophy, hematoma, abscess, lymphoma, pelvic lipomatosis, RP fibrosis, IVC obstruction
Bladder fistulas
diverticulitis, Crohn’s, CA, surgery, radiation
Bladder diverticula
congenital (Hutch, urachal), acquired (BOO)
Bladder rupture
trauma, radiation, tumor, cystitis, neurogenic bladder
“Female prostate”
central filling defect at base of bladder; urethral diverticulum, urethral tumor, periurethritis, pubic bone lesion
Urethral stricture
GC, trauma, iatrogenic
Adrenal masses
tumor - adenoma, mets (esp small cell), pheochromocytoma, lymphoma, neuroblastoma, carcinoma, hemangioma; fatty – adenoma, myelolipoma, lipoma; cystic – simple cyst, pseudocyst from hemorrhage; other – hemorrhage, TB, Wolman’s disease; bilateral – hemorrhage, mets, lymphoma, bilateral pheochromocytoma (MEN2, VHL, NF), TB, histo, adenomas, hyperplasia
Adrenal calcifications
tumor – neuroblastoma, pheochromocytoma, carcinoma, myelolipoma, hemangioma; infection – TB, histo, meningococcemia; trauma – hemorrhage; congenital – Wolman’s, Addison’s; cyst
Adrenal pseudotumors
gastric fundus, varices, tortuous splenic artery, pancreatic tail, medial splenic lobulation
Large retroperitoneal mass
hematoma, abscess, adenopathy from lymphoma or mets, liposarcoma, leiomyosarcoma, MFH, neurogenic tumor, germ cell tumor
Retroperitoneal hematoma
anticoagulation, trauma, iatrogenic, ruptured AAA, RCC, AML
Retroperitoneal air
trauma (perforation), ERCP, emphysematous pyelonephritis
Retroperitoneal abscess
pancreatitis, renal inflammatory disease, osteomyelitis
Retroperitoneal fibrosis
idiopathic, methysergide, radiation, surgery, lymphoma, mets, retroperitoneal fluid, inflammation from other organs