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Flashcards in GU Deck (94)
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1

Duplicated collecting system - what inserts where?
What's the problem with the upper pole ureter?
What's the problem with the lower pole ureter?

Upper pole inserts inferomedially and ectopically. Obstructs, usually ureterocele.
Lower pole refluxes, inserts normally.

2

Differences among sepate, arcuate, bicornuate, didelphys

Septate- normal fundal contour, muscular and/or fibrous septum (needs to be removed)
Arcuate-normal outer contour, slight dip in myometrium, no consequence (fairly normal, actually)
bicornuate- separated horns/dip in contour
didelphys- separate uterus including cervix

3

Ddx for cortical nephrocalcinosis

*chronic glomerulonephritis
*acute cortical necrosis
*rejected renal transplant
*Alport syndrome
*oxalosis
putty kidney from TB
renal infarction / ischaemia
sepsis
drugs
hemolytic uraemic syndrome (HUS)

4

Ddx for medullary nephrocalcinosis

*hyperparathyroidism
*medullary sponge kidney
*renal tubular acidosis
hypervitaminosis D
milk-alkali syndrome
sarcoid
other pathological hypercalcemic or hypercalciuric states

5

What's medullary sponge kidney?

The medullary and papillary portions of the collecting ducts are dysplastic and dilated and in most cases develop medullary nephrocalcinosis.

6

Ddx renal hemosiderosis

sickle cell
thalassemia
*Paroxysmal nocturnal hemoglobinuria
mechanical valves causing chronic hemolysis

7

Ddx striated nephrogram (unilateral)

Pyelonephritis
obstruction
renal vein thrombosis
(contusion, radiation)

8

Ddx striated nephrogram (bilateral)

acute pyelonephritis
acute tubular necrosis (e.g. from contrast)
hypotension
infarcts/PAN
SLE
lymphoma

9

What stage is an RCC with IVC extension below the diaphragm? Above?

T3b
T3c for above

10

Ddx retroperitoneal adenopathy

lymphoma
mets from testicular, prostate, endometrial, cervical
infection: TB, HIV

11

On what side should scrotal varicoceles raise concern?

the right side is abnormal and raises concern for an RP mass
80% of varicoceles are left-sided

12

large mass ~upper pole kidney

RCC, adrenal cortical carcinoma, pheo, mets, retroperitoneal sarcoma, malignant fibrous histiocytoma

13

hysterosalpingogram - diverticula off tube

Salpingitis isthmica nodosa (asociated with PID, infertility, ectopic pregnancy)
Tubal TB
tubal endometriosis

14

when you see a large adnexal nonvascular (noncystic) mass, what should you include?

ovarian torsion

15

Parts of the male urethra, bladder out:
Where is the verumontanum? Where are posterior urethral valves?

prostatic, membranous
bulbar (turns and becomes horizontal), penile
verumontanum is posterior of prostatic portion, posterior urethral valves begin here and go to distal prostatic urethra

16

Ddx for male urethral stricture

Carcinoma (TCC in prostatic, adeno (at Cowper's glands just below prostate), squamous cell (from prior stricture of anterior urethra)
Post-infectious stricture
post-catheter stricture (penoscrotal jctn or membranous)

17

Ddx for fat-containing mass in region of adrenal gland

myelolipoma of adrenal gland
AML of kidney
liposarcoma
HCC/adeno of liver

18

ddx for renal papillary necrosis (sloughing of papilla)

P : pyelonephritis
O : obstruction
S : sickle cell disease
T : tuberculosis
C : cirrhosis
A : *analgesic abuse* - NSAIDS
R : renal vein thrombosis
D : *diabetes mellitus*
S : systemic vasculitis/des

19

ddx of omental caking

mets (ovarian, GI, pancreas, GB)
TB
Lymphoma
Mesothelioma

20

Pt with rcc and multiple renal cysts might have?
What other features of this diz?

think vHL
also have pheos, pancreatic islet cell tumors and panc cysts
cerebellar and retinal hemangioblastomas

21

numerous cysts in atropied kidneys

acquired renal cystic disease of dialysis
increased risk of RCC

22

What's adenomyosis? What dx criteria?

the presence of ectopic endometrial tissue within the myometrium
junctional zone greater than 12mm

23

Bosniak renal cyst classification system:

1-simple
2-single thin septation or thin calc or high attenuation non-enhancing
2F-thicker septations or thicker calc
3-more complex
4-obviously malignant, a lot of solid parts
1 & 2 - no follow-up, never malignant
2F-4 - follow-up

24

renal mass with multiple cysts, herniates into renal pelvis - what is it? Who gets it?

Multilocular cystic nephroma
males under 5
women in their 40s

25

Hysterosalpingogram - intrauterine senechiae

Asherman's syndrome, usually 2/2 D&C, IUD, severe endometritis

26

causes of RP fibrosis

idiopathic, meds, blood (rp bleed), radiation, peri-aneurysmal, malignancy

27

Ureters pushed away from spine vs pulled medially - what does that distinguish?

Pushed away - lymphoma
Pulled medially - RP fibrosis

28

Ddx of multiple filling defects of ureter

spreading or multifocal TCC
vascular indentations
multiple ureteral stones (steinstrasse)
blood clots
ureteritis cystica
Stevens-Johnson syndrome
Malakoplakia (benign, related to chronic infection)

29

What's ureteritis/pyeloureteritis cystica?

benign supepithelial cysts, likely 2/2 chronic UTIs

30

Where does prostate cancer usually originate?

Peripheral zone (thus easy to feel on rectal exam)