Gu Cases 4

Front 1

does malignant degeneration occur in multilocular cystic nephroma

Back 1

no, but can be difficult to differentiate from a cystic RCC so must be resected

Front 2

causes of hydrosalpinx

Back 2

infx
adhesions
endometriosis
ectopic pregnancy

Front 3

appearance of hydrosalpinx on HSG

Back 3

contrast may or may not fill the dilated tube

Front 4

findings of pelvic floor descent

Back 4

midline location of a descended bladder along with descent of uterus

Front 5

why does the bladder not completely empty in pelvic floor descent

Back 5

the bladder descends below the level of the urethral meatus -> recurrent infx, hydronephrosis

Front 6

what is a urinary bladder hernia

Back 6

when the bladder herniates through the usual hernial orifices
virtually never occurs in midline

Front 7

where does TCC of the ureter most commonly occur

Back 7

distal 1/3 of the ureter

Front 8

in trauma, mechanism of intraperitoneal bladder rupture
what part of the bladder is injured

Back 8

direct blow to a distended bladder
usually affects the bladder dome

Front 9

which type of bladder rupture is most common in setting of trauam

Back 9

extraperitoneal bladder rupture

Front 10

where does contrast go in intraperitoneal rupture

Back 10

outlines loops of bowel

Front 11

is space of retzius intra- or extra-peritoneal

Back 11

extra

Front 12

etiologies for hematocele

Back 12

trauma
surgery
neoplasm

Front 13

are septations seen in hematocele

Back 13

yes

Front 14

next step if a complex hydrocele is seen

Back 14

evaluate for a mass

Front 15

appearance of a uterine lipoleimyoma

Back 15

fat containing mass within the uterus, usually surrounded by myometrium
most often arise from the fundus

Front 16

fat containing lesions of the uterus

Back 16

lipoleiomyoma
angiomyolipoma
fibrolipoma
fat containing sarcomas

Front 17

who gets lipoleiomyomas

Back 17

women 50-70 yo

Front 18

#1 uterine neoplasm

Back 18

leiomyoma

Front 19

where are subserosal fibroids located

Back 19

near the SURFACE

Front 20

whorled appearance in a uterine mass is characteristic of what

Back 20

leiomyoma

Front 21

best sequence to assess fibroids

Back 21

T2

Front 22

what is the CT protocol to assess for adrenal lesions

Back 22

NECT
1 minute post-contrast
10-15 minute delayed imaging

Front 23

what role does PET play in evaluating renal lesions

Back 23

false + seen if its a fxning adrenal adenoma
false negatives are seen wiht mets from RCC

Front 24

appearance of testicular infarct

Back 24

flow is absent
small testicle
hypoechoic testicle

Front 25

when must detorsion be performed for testicular torsion

Back 25

<6 hrs from time of onset

Front 26

grayscale appearance of a torsed testicle

Back 26

may initially be nml, but then the testis becomes swollen and hypoechoic b/c of edema

Front 27

role of doppler in testicular torsion

Back 27

abscence of blood flow occurs by 4 hors
if torsion is partial, it may manifest a relative dampening of signal on the affected side

Front 28

what NM study can be done to evaluate for testicular torsion
what will the findings look like

Back 28

tc99m-pertechnetate (will show decreaesd perfusion in acute cases, with absence of activity on affected side. in subacute cases, will see donut sign (central paucity of activity, with increased activity at the rim)

Front 29

if blood flow is present in both testes, but is asymmetric what should be evaluated next

Back 29

spectral waveforms should be obtained and compared to look for dampening of flow on affected side

Front 30

what absolute washout % would indicate adrenal adenoma

Back 30

>60%

Front 31

formula to calculate adrenal lesion washout

Back 31

absolute w/o = enhancement w/o / enhancement

relative w/o = enhancement w/o / immediate attenuation

enhancement = immediate - noncontrast
enhancement w/o = immediate - delayed

Front 32

what relative w/o would indicate a benign adenoma

Back 32

>40-50%

Front 33

lesions splaying the limbs of the adrenal glands most likely arise from where

Back 33

the adrenal glands

Front 34

most common cause of hematotmetrocolpos in older women

Back 34

vaginal CA

Front 35

cause of hematocolpos in oder woemn

Back 35

cerivcal CA

Front 36

complications of psoas hematomas

Back 36

hypovolemia
abscess

Front 37

management of an uncomplicated psoas hematoma

Back 37

NTD, will resorb on its own

Front 38

most common cause of hydronephrosis in neonate

Back 38

UPJ obx

Front 39

post-obx atrophy

Back 39

decrease in size of a kidney after relief of chronic obx

Front 40

pathophys of post-obx atrophy

Back 40

in pts with chronic unilateral urinary tract obx and hydro, renal parenchyma atrophies although the size of kidney doesn't decrease b/c fo large dilated cs
when obx is relieved, the kidney collapses
there is still mild prominence of the cs even after obx is relieved

Front 41

before what age can the contralateral kidney hypertrophy as compensation for post-obx atrophy

Back 41

<40 yo

Front 42

how to differentiate post-obx atrophy from renal vasc disease

Back 42

cs never retunrs to nml even after relief of chronic obx and there is always some residual dilatation
this does not occur in vascular atrophy

Front 43

next step when you see a bladder tic

Back 43

always look for a cause of bladder outlet obx and evaluate for hydroureteronephrosis
also, always eval tic for focal wall thickening of filling defects that may suggest malignancy

Front 44

most common site of undescended testes

Back 44

inguinal canal

Front 45

before what age does an undescended testicle have to be repaired in order for it to maintain fxn

Back 45

<6 yo

Front 46

calcified testiculuar mass think:

Back 46

burnt out testicular tumor

Front 47

what is burnt out testicular tumor

Back 47

the name given to a calcified scar in the testicle that is left behind after asponatneous regression of germ cell testicular neoplasm
even if the tumor has regressed, viable neoplastic cells may be present, esp to mediastinum

Front 48

if burnt out testicular tumor is found, next step

Back 48

CT C/A/P to look for extra-gonadal spread

Front 49

if extra-gonadal spread is seen in a burnt out testicular tumor, next step

Back 49

orchiectomy

Front 50

what type of malignancy results if a teratoma has malignant degeneration

Back 50

SCC, from the skin elements

Front 51

complications of dermoid

Back 51

ovarian torsion
chemical peritonitis

Front 52

pathophys of ovarian torsion

Back 52

first blocks venous drainage -> ovarian enlargement, then ovarian cyst wall and hemorrhage into cyst amay also occur
twisted adnexa are shortened and pull uterus ipsilaterally
eventually, arterial supply is compromised -> infarct

Front 53

CT findings of ovarian torsion

Back 53

well defined adnexal mass due to enlarged ovary
ipsilateral deviation of uterus
fat stranding in pelvis

Front 54

t or f: ovarian neoplasms do not show hemorrhage

Back 54

true, hemorrhage is a reliable sign of benignity