Renal cysts

Question 1

What are renal cysts?

Answer 1

fluid filled sacs found in the kidney which can be simple or complex

Question 2

What are simple renal cysts?

Answer 2

well defined outline with homogeneous features

Question 3

Who are simple renal cysts common in?

Answer 3

50% in those over 50 years

Question 4

What do simple renal cysts develop from?

Answer 4

renal tubule epithelium due to previous ischaemia

Question 5

What are complex renal cysts?

Answer 5

thick walled, separations, calcification or heterogeneous enhancement on imaging

Question 6

How are complex renal cysts classified?

Answer 6

Bosniak classification

Question 7

What are complex cysts at risk of?

Answer 7

Becoming malignant

Question 8

What are the risk factors for renal cysts?

Answer 8

increasing age, smoking, hypertension, male, genetic conditions

Question 9

What genetic conditions increase risk of renal cysts?

Answer 9

PKD, tuberous sclerosis and von hippie-lindau disease

Question 10

What mutation is present in APKD?

Answer 10

PKD1 or 2

Question 11

What may form in someone with APKD?

Answer 11

Berry aneurysm leading to subarachnoid haemorrhage, mitral valve disease, liver cysts

Question 12

What are the clinical features of renal cysts?

Answer 12

usually found incidentally on imagine but may get flank pain if rupture or infected or haematuria

Question 13

How do people with PKD present?

Answer 13

uncontrolled hypertension and maybe a flank mass

Question 14

How do you diagnose renal cysts?

Answer 14

CT or MRI with pre and post enhancement scans with IV contrast, ultrasound may pick it up but will need further imaging

Question 15

What blood test should be checked in renal cysts?

Answer 15

U and E to make sure it is not impacting the patients renal function

Question 16

When should CT be done and when should MRI be done with renal cysts?

Answer 16

I-IIF= CT

IIF-IV- MRI

Question 17

What are the different stages of the Bosniak stage?

Answer 17

I-IV and goes from simple=I all the others are complex and more likely to be malignant

Question 18

What is the management of renal cysts?

Answer 18

if asymptomatic they need no treatment or follow up, is symptomatic and simple then analgesia or maybe needle aspiration or cysts deroofing may be needed, if complex then surveillance or surgical intervention e.g. nephrectomy

Question 19

What are the complications of renal cysts?

Answer 19

infection, haemorrhage and rupture