Radiology

Question 0

IV Pyelogram

Answer 0

Being replaced by CT; kidneys excrete contrast into the collecting ducts, ureter, bladder, and urethra

Question 1

Plain films

Answer 1

Cheap and widely available; however, they are rarely diagnostic

*

Question 2

CT Scans

Answer 2

Arterial Phase (10s)- Shows renal artery and vein; good differentiation b/w cortex and medulla

Nephrogram phase (60s)- detects renal parenchyma lesions

Pyelogram (4 mins)- excreted into the ureters; shows urolithiasis well
*This phase has the most variable appearance

Question 3

Ultrasounds

Answer 3

Allow for the real-time assessment of blood flow; can differentiate solid from cystic lesions

Question 4

MRI

Answer 4

Unable to image Ca2+; cant ID stones

Question 5

Retrograde Pyelography

Answer 5

Performed in pts. who may have a contrast allergy for CT scans; commonly stent placement or stone removal follows

Question 6

Acute Bacterial Pyelonephritis

Answer 6

“UTI”

Vesicouretal reflux => E. coli

Hematogenos => S. aureus

*Often see a “striated nephrogram” where there are alternating stripes of parenchyma caused by edema

Question 7

Renal Abscess

Answer 7

Flank pain, pyuria, and fever

*CT scans have high sensitivity, low specificity

Question 8

Emphysematous Pyelonephritis

Answer 8

Kidney infection w/ production of gas

Type 1- destruction of 1/3 of kidney; high mortality

Type 2- Low destruction; low mortality

*Treatment= nephrectomy

Question 9

Xanthogranulomatous Pyelonephritis

Answer 9

Chronic infxn w/ renal parenchyma replacement by lipid-filled macrophages

=>Renal enlargement, canaliculi

Question 10

Renal Cysts

Answer 10

*Most common renal focal lesion

Question 11

Renal Cell Carcinoma

Answer 11

Cystic and solid components w/ the solid increasing in size

Question 12

K+ during acidosis

Answer 12

H+ moves into cells causing K+ to move out

Question 13

Femoral Structures

Answer 13

NAVL
Nerve

“Sheath”= Artery, Vein, Lymphatic

Question 14

Heart structure @ right mediastinum

Answer 14

Right Atrium

Question 15

Heart Structure @ Left Mediastinum

Answer 15

Left ventricle

Question 16

Airspace Opacity

Answer 16

Will appear colored if filled w/ dense material such as pus or blood

Question 17

Interstitial Opacity

Answer 17

Can be thin linear, reticular, or nodular opacities

Question 18

Air Bronchogram Sign

Answer 18

Tubular outline of medium and large bronchi made visible by alveolar filling

=> indicative of alveolar disease

Question 19

Silhouette Sign

Answer 19

Airspace opacity resulting in loss of lung-mediastinum or lung-diaphragm interface

Question 20

Location of diaphragm at inspiration

Answer 20

Rib 10

Question 21

Lordotic x-ray

Answer 21

Clavicles appear above head; camera angle placed up towards head

Question 22

Aunt Minnie

Answer 22

Radio graphic findings that are pathognomic for something

Question 23

Atelectasis effect on mediastinum

Answer 23

Shifts to side of affected lung

Question 24

Lung cancer

Answer 24

Solitary => Primary lung carcinoma Multiple lesions => Metastatic

Question 25

Perinephric spaces

Answer 25

Contains the kidneys, adrenal glands, ureters, and perirenal fat *Has a thick posterior compartment formed by fascia

Question 26

Anterior Pararenal Spaces

Answer 26

Slightly anterior to the perinephric spaces CONTAINS: Duodenum, IVC, Pancreas, Aorta, and ascending/descending colon Formed by posterior parietal peritoneum (anteriorly) and the anterior renal fascia (posteriorly)

Question 27

Posterior Pararenal space

Answer 27

Posterior and lateral to perinephric spaces Contains fat; formed by posterior renal fascia (anteriorly) and transversalis fascia (posteriorly)

Question 28

Retrograde urethrogram

Answer 28

Contrast injected into male urethra; indications are for stricture or trauma

Question 29

As tubular fluid moves down the PT

Answer 29

It remains isosmotic relative to plasma