Imaging Studies of the GUT

Question 1

Function as interim kidneys for approximately 4 weeks, until the permanent kidneys develop

Answer 1

Mesonephros

Question 2

2. The pronephros regresses completely during

Answer 2

End of 4th Week

Question 3

3. the mesonephros degenerates during

Answer 3

End of 1st trimester (3rd month)

Question 4

4. This structure induces the development of the definitive kidney

Answer 4

Ureteric bud

Question 5

5. This structure forms the definitive kidney. It appears in the 5th week of development and becomes functional around 12th week

Answer 5

Metanephros

Question 6

6. The 2 components of metanephric system

Answer 6

Collecting system and Excretory System

Question 7

7. This system is derived from the Ureteric bud. It dilates to create the ureter, renal pelvis, major and minor calyces and collecting tubules.

Answer 7

Collecting system

Question 8

8. This system is derived from the metanephric blastema which forms the kidney’s functional unit.

Answer 8

Excretory System

Question 9

9. The cloaca which is a common chamber for gastrointestinal and urinary waste will be divided into two parts by the uro – rectal septum during___.

Answer 9

4th – 7th week of development

Question 10

10. The urinary badder is initially drained by the ____ which will later become the _____

Answer 10

Allantois; Urachus

Question 11

11. This is the remnant of the Urachus

Answer 11

Median Umbilical Ligament

Question 12

12. Indications for KUB X – ray

Answer 12

Kidney stones
Abnormal calcifications
Renal agenesis

Question 13

13. Limitations of KUB X -ray

Answer 13

Renal outline may be obscured by bowel gas
Radiation exposure
No functional information
Retained barium from other procedures that may interfere with visualization

Question 14

14. Radiographic study of the renal parenchyma, pelvicalyceal system, ureters, and urinary bladder. Largely replaced by CT urography.

Answer 14

Intravenous Urography

Question 15

15. Indications of Intravenous Urography

Answer 15

Check for normal function of kidneys
Check for anatomical variants or congenital anomalies
Check the Course of the Ureters
Detect and Localize a Ureteric Obstruction (Urolithiasis)
Assess for synchronous upper tract disease in those with bladder transitional cell carcinoma

Question 16

16. Fluoroscopic study of the lower urinary tract in which contrast is introduced into the bladder via a catheter

Answer 16

Voiding Cystourethrography

Question 17

17. Grade and corresponding manifestation of VUR

Answer 17

Grade I – VUR into a non – dilated ureter
Grade II – VUR into the upper collecting system without dilation
Grade III – VUR into dilated ureter and/or blunting of calyceal fornices
Grade IV – VUR into grossly dilated ureter
Grade V – Massive VUR, with significant ureteral dilation and tortuosity and loss of the papillary impression

Question 18

18. In performing renal ultrasound these parameters should be look out for

Answer 18

Kidney Size
Location
Renal Outline
Corticomedullary Differentiation

Question 19

19. T or F. In a normal ultrasound, the cortex appears hyperechoic (bright) while the medulla appears hypoechoic.

Answer 19

T

Question 20

20. Hydronephrosis would appear ____ in ultrasound

Answer 20

Calyceal Splitting.

In cases with distal obstruction proximal end of dilated ureter may be seen

Question 21

21. Calculi would appear as ____ in ultrasound

Answer 21

Echogenic (Bright) structures in distal acoustic shadowing

Question 22

22. Screening Modality of choice for Renal Artery Stenosis

Answer 22

Ultrasound

Question 23

23. Excellent cross-sectional imaging modality that provides functional information as well. Checks kidney function before contrast administration. Non – ionic contrast is preferred because of reduced side effects

Answer 23

CT Stonogram/Urogram

Question 24

24. Limitations of CT Stonogram/Urogram

Answer 24

Radiation Exposure
Expensive
Contrast Exposure

Question 25

25. Indications of CT Stonogram/Urogram

Answer 25

Renal Stone Disease Renal/Bladder Massess Trauma

Question 26

26. Renal Stone Disease present as ____ hematuria

Answer 26

Painful

Question 27

27. Renal/Bladder Masses present as _____ hematuria

Answer 27

Painless

Question 28

28. Becoming the gold standard for detection of renal calculi

Answer 28

Non – contrast CT

Question 29

29. This result from failure of the kidneys to ascend from the true pelvis into the lumbar region

Answer 29

Renal Ectopia

Question 30

30. Most common form of Renal Ectopia

Answer 30

Pelvic Kidney

Question 31

31. What condition is characterized by the fusion of kidneys at lower pole by a parenchymal or fibrous isthmus.

Answer 31

Horseshoe Kidney

Question 32

32. Horseshoe Kidney is associated with these conditions

Answer 32

Ureteropelvic junction obstruction, ureteral duplication, and genital tract anomalies.

Question 33

33. This is a non – neoplastic benign saclike structures containing fluid

Answer 33

Simple Renal Cyst

Question 34

34. Simple Renal Cyst is most commonly found in what area of the kidney

Answer 34

Renal Cortex; less commonly in parenchymal or parapelvic location

Question 35

35. Modality of choice for Renal Cyst

Answer 35

Ultrasound

Question 36

36. Pathognomonic Findings in Simple Renal Cyst

Answer 36

Spherical or slightly ovoid shape, homogenous internal structure and smooth margin

Question 37

37. Intravenous Pyelogram Findings of Simple Renal Cyst

Answer 37

Splaying of calices by smooth tumor

Question 38

38. The following would point to Atypical Cyst

Answer 38

Intracystic calcification and thickened wall Higher viscosity of cyst fluid Septa Homogenous Internal Structure and Smooth wall

Question 39

39. These are classified under Complicated Cyst

Answer 39

Hemorrhagic Cyst –simple cyst secondarily affected by hemorrhage due to trauma or hemorrhagic diathesis Infected Cyst - VUR, hematogenous infection Ruptured Cyst

Question 40

40. This is a malignant epithelial tumor of the renal parenchyma usually arising in the renal poles

Answer 40

Renal Cell Carcinoma

Question 41

41. Modality of Choice for RCC

Answer 41

Biphasic CT/MRI after intravenous contrast administration | Ultrasound

Question 42

42. Pathognomonic Finding of RCC

Answer 42

Solid tumor of the renal cortex with rich vascular supply | Pseudocapsule

Question 43

43. Refers to the presence of calculi anywhere along the course of the urinary tract

Answer 43

Urolithiasis

Question 44

44. Most common stone

Answer 44

Calcium Oxalate

Question 45

45. Calcium – containing stones appear ___ on plain radiograph

Answer 45

Radiopaque

Question 46

46. Struvite (Triple phosphate) appear _____ on plain radiograph

Answer 46

Usually Opaque but variable

Question 47

47. Lucent Stones Include the following ____

Answer 47

Uric Acid, cystine, Indinavir Stones, Pure matrix stones

Question 48

48. Urolithiasis would present the following features in ultrasound

Answer 48

Echogenic Foci Acoustic shadowing Twinkle artifact on color Doppler Color comet – tail artifact