imaging the urinary tract

Question 1

what can a raised creatnine indicate about the kidney

Answer 1

kidney injury -> look for old bloods and check for changes

Question 2

what is the underlying cause of intrinsic, post-renal AKI

Answer 2

blockage e.g. stone, tumour

Question 3

what is the underlying cause of extrinsic, post-renal AKI

Answer 3

pressure from external structures e.g. pelvic masses

Question 4

what is the underlying cause of renal AKI

Answer 4

glomerulonephirits

Question 5

what is the first line radiological investigation for AKI

Answer 5

ultrasound

Question 6

how does fat appear on ultrasound

Answer 6

bright

Question 7

how does a normal kidney appear on US

Answer 7

semicircular(ish) area of dark with a lighter central section (in the shape of the kidney parenchyma and renal pelvis

Question 8

how do fluids appear on US

Answer 8

black -> if the renal pelvis is black it indicates that it is filled w urine -> blockage

Question 9

how might a CKD kidney appear on US

Answer 9

1. smaller
2. thin cortex
3. increased renal sinus fat

Question 10

what is urolithiasis

Answer 10

calculi (stones) or the renal/urinary tract and bladder

Question 11

best imagine modality for urolithiasis

Answer 11

CT

Question 12

what is fat stranding

Answer 12

abnormal increased attenuation in fat on CT

Question 13

what renal conditions is fat stranding seen on CT (2)

Answer 13

1. acute pyelonephritis
2. ureteric calculi

Question 14

what does a widened ureter indicate on CT

Answer 14

obstruction

Question 15

what is twinkling artifact on US

Answer 15

seen on colour flow doppler ultrasound - a focus of alternating colours on Doppler signal behind a reflective object (such as a calculus or air), which gives the appearance of turbulent blood flow

Question 16

what is a ureteric jet

Answer 16

on colour doppler US urine can be seen jetting out of the ureter into the bladder -> if this occurs at a certain velocity then it indicated NO obstruction

generally used in pts who cant hv a CT -> pregnant/ young pts

Question 17

causes of nephrocalcinosis (3)

Answer 17

1. hyperparathyroidism
2. renal tubular acidosis
3. medullary sponge

Question 18

what is renal tubular acidosis

Answer 18

damage to the kindeys meaning that acid-base balance cannot be kept in balance as waste is not being removed

Question 19

what is US used for in renal cystic disease

Answer 19

diagnosis

Question 20

what is CT/MRI used for in renal cystic disease

Answer 20

check up/monitoring -> CT used far more

Question 21

what are poly cystic kidneys

Answer 21

a genetic disorder that causes many fluid-filled cysts to grow in your kidneys

Question 22

how do cycts appear on imaging

Answer 22

1. fluid filled
2. homogenous
3. thin wall

Question 23

what imaging can be used for renal vascular disorders

Answer 23

MR angiogram

Question 24

what is a con of MR renal angiography

Answer 24

very invasive proceedure

Question 25

what is digital subtraction angiography

Answer 25

a fluoroscopy technique used in interventional radiology to clearly visualize blood vessels in a bony or dense soft tissue environment

Question 26

how do renal infarcts appear on CT

Answer 26

1. wedge shaped lesions
2. non-homogenous kidney
3. cortical rim sign

Question 27

what is pyelonephritis

Answer 27

UTI that spreads to the kidneys

Question 28

what is pyelonephritis easy to confuse with on CT

Answer 28

renal infarct -> Hx is key in determining diaagnosis

Question 29

renal abscess features on CT (3)

Answer 29

1. well defined mass
2. thick wall
3. fat stranding