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77 Cards in this Set
- Front
- Back
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what are the 2 most common imaging modalities to look at the kidneys an urinary tract
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CT and Ultrasound
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what do you use a MRI for in the kidneys? 2
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used to characterize renal tumors w/o biopsy
also to look at vasculature to see stenosis |
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if a pt has any of the following, what imaging method should you order:
Flank pain, suspected GU calculus Abdominal pain, unknown etiology Follow up known GU calculus Hematuria |
plain Xray
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how do you see a renal artery anuerysm?
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curvy linear calcification
prob not on test but maybe on boards |
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what is the first artery to calcify in the body
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splenic
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what is the psoas stripe (shadow)?
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it is the psoas muscle and can show diff paths
this is prob gonna be an xray |
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3 places you can see a kidney stone (commonly)
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right as it comes out the uteropelvic junction
pelvic inlet/brim (where they cross iliac vessels) right before it enters the bladder (ureterovesicular junction) |
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psoas margin
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calculus at UP junction
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pain from kidney stones occurs due to?
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stone rubbing on urterer
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yellow arrows
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phleboliths
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What is a Pelvic Phlebolith?
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Phleboliths are masses, deposits or growths which develop in the wall of a vein and are composed of calcium or lime
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what are some of the things you are looking for in xray of the abodmen
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Stones bones masses and gasses
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what are the Houndsfield numbers for air, water, and fat...
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water= 0 (up to 20)
air= -1000 fat=small minus (-50ish) any number minus number less than air (even -100!) also cyst is around -15-20 on CT when you put your mouse over something on the image, it gives you a number. so you can tell what that something is based on the number.. Aka if you put your mouse over something and the number is -40 you would have a fatty cyst |
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propertoneal fat line distortion
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oblique is used on plain film for what
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to triangulate where a density is
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1. Air
2. Fat (-50) 3. Soft Tissue 4. Calcification |
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Most often requested to evaluate suspected ureteral obstruction
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Intravenous Pyelogram
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what is are the 2 types of contrast and which is most common?
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ionic
non ionic: more common (more expensive but safer) |
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if you are allergic to shell fish can you still get IVP
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yes!! they used to think not, but you can..
this could show up on the exam |
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big pro of IVP?
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Demonstrates exact level of obstruction
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if there is an allergy to contrast, what should be your #1 modality to image the kidney?
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Ultrasound
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all of the following are what?
History of hypersensitivity Combined renal and hepatic disease Oliguria Serum creatinine > 2 mg/ml Diabetes with renal insufficiency Glucophage Multiple myeloma |
Contraindications to contrast
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Even the smallest calcifications are visible with ____?
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CT!
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what is the most important thing that an ultrasound can show? what is another major benefit?
*You will need to be able to recognize an ultrasound |
Can differential cyst from solid
No radiation |
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right kidney
can see liver next to it black is renal cortex middle is central renal core (can't see collecting structures) |
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what is shown? what is the sign?
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Renal cyst (smooth marginated, anechoic (without echoes)
Beak sign: edge of cyst comes up to the cortical margin |
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what is being shown
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a solid
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scout for calculus disease use what imaging modality?
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Plain film
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acute urinary obstruction use what?
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IVP
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if allergic to iodine or to confirm cyst or to avoid radiation use what imaging modality?
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Ultrasound
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If information is desired about the renal arteries or if renal diagnosis still unclear use what imaging modality
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MRI
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excellent and preferred cross sectional anatomy..use what modality?
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CT
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must know
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from top down:
Calyx Infundibulum Pelvis Ureter |
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what are the 3 causes of filling defects?
*TEST |
Stone
Clot Tumor |
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IVP shows what 3 structures well?
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KUB
kidney ureter bladder |
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8. Aorta
5. Top of adrenal gland 7. Inferior vena cava 9. Portal vein 11. Intestine 1. Liver 12 descending colon 3. Pancreas 4. Gall bladder 5. adrenal |
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which is left kidney?
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17
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psoas shadow
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what is 20?
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L renal vein
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most common abdominal mass in a kid
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hydronepherosis
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what is the diagnosis?
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"Bear paw"
hydronephrosis |
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2 most common renal cancers?
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Transitional cell carcinoma
Squamous cell |
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where are the most renal calculi found?
due to? |
medullary
hyper Ca |
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if you suspect kidney or ureteral calculus what do you order 1st? 2nd?
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Abdominal x-ray
Renal CT |
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what is a staghorn calculus?
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calculus that “grows” to fill the collecting system
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what is the most common mass you will see in a kidney?
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SIMPLE renal cyst
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simple cyst is best seen with what?
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ultrasound
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path?
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polycystic kidney disease
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simple cyst is best seen with what?
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ultrasound
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path
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Polycystic Kidney Disease
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round: cyst
crappy: cancer |
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what is this based on the number
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fat
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About one-third of patients have ____ at the time of diagnosis of renal cancer.
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metastasis
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叉子
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chāzi
Gabel |
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Subcapsular Hematoma, complication of biopsy
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diagnosis?
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Angiomyolypoma
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Cyst/renal cancer/or fatty tumor?
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Cysts 0-20
and rounded so CYST |
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renal abcess
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renal laceration
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another name for renal fascia is?
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Gerota's fascia
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kidneys are fused at their lower poles =
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horseshoe kidney
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Horseshoe kidney
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extra kidney
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most common cause of calcification of urinary wall?
****TEST |
bladder schistosomiasis (parasitic disease)
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bladder schistosomiasis
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adrenal gland best imaged by what?
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CT
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CT numbers below zero help confirm what?
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adenoma
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adrenal is a Common organ for lung cancer ____
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metastasis
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adrenal adenoma
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History =Trauma
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Fractured kidney
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gross hematuria is seen in what?
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renal laceration
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24% of patients with renal pedicle injury have no ___
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hematuria
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Cresentic lesion below the capsule, due to biopsy (subcapular hematoma)
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History: automobile accident
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Avulsion of the right renal artery with perfusion deficit
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With major injury, one kidney lights up bright, the other is darker….
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just know that
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WHAT TO KNOW FOR TEST:
1. person shows up with urinary tract complaint, looking for stone.. what do you do first? 2. Abscess vs. Cyst 3. What study do you do if someone is allergic to contrast 4. In renal masses, what is most common? 5. Mass you can measure fatty measurements in, don't need to biopsy 6. kidney stones are most commonly visible under plain film xray as very dense structures but.... 7. most stones of what size will pass no prob? 8. what is similar in nature to the AML but found in the adrenal gland? |
1. plain film abdominal xray
2. Cyst will never have air in it, will be nice and round. Abscess has air, is bigger, gas filled 3. Ultrasound 4. Cyst 5. -40ish on CT (so you know this is an AML and is begin by nature, thus you can disregard) 6. 5-10% can't be seen with uric or cysteine acid (Cysteine and uric acid stones are radiolucent ) 7. 6mm 8. AML and myolypoa are close to the same kind of lesion (multiple cell types, fat & muscle) |
