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Flashcards in Renal Deck (233)
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1

The right kidney is lower on the right what % of the population?

85%

2

Kidney ptosis greater than how many cm is considered pathological when going from supine to upright films?

5cm (1.5 vertebral bodies)

3

The kidney continue to keep on growing until what age?

20

4

If the right kidney is greater than the left kidney by _____ OR if the left kidney is more than ______ longer than the right kidney, it is considered pathological.

1-1.5cm; 2cm

5

Embryonically, how do the kidneys originate?

Fused, in the fetal pelvis with the renal pelvis facing anteriorly.

6

What % of the pop'n have an accessory renal artery? What % is unilateral and what % is bilateral?

30%

Unilateral = 30%; bilateral = 10%

7

What are the basic features of renal agenesis?

- ipsilateral usually (bilateral rare & incompatible w/ life)
- absence of ipsilateral trigone & ureteral orifice
- absence of renal artery
- contralateral kidney hypertrophied
- adrenal gland absent (8-10%)

8

How is left renal agenesis identified on plain film?

By medial dislocation of the splenic flexure.

9

What are the basic features of renal hypoplasia?

- kidney small but still functional
- major calyces absent or fewer
- but renal artery, pelvis & parenchyma all NORMAL

10

What complications can arise with renal hypoplasia?

a. primary hypertension
b. chronic renal failure

11

What determines the size of a hypoplastic kidney?

The number of nephrons created during embryological development.

12

What is the main differential diagnosis of renal hypoplasia?

Acquired renal atrophy (eg. chronic ischemia, long-standing obstruction)

13

What is renal dysplasia?

- small kidney but no function

14

On what side is a supernumerary kidney most commonly found and where is it in relation to the dominant kidney?

Left side and more caudally placed, hypoplastic & fused to dominant kidney.

15

What symptoms are associated with a supernumerary kidney?

Incidental finding

16

What are the two types of collecting systems seen with a supernumerary kidney?

1st type: bifid ureter drains both kidneys

2nd type: a separate ureter drains the supernumerary kidney

17

Other than CT and US, what are two modalities used to diagnose supernumerary kidney?

1. Angiography -- demonstrates a separate vascular supply

2. IVP -- see separate collecting system

18

What normal variant represents hypertrophied cortical tissue between medullary pyramids that projects into renal sinus?

Septum of Bertin

19

What is the M/C fusion anomaly of the GU tract?

Horseshoe kidney

20

Where is the isthmus of a horseshoe kidney in relation to the aorta & IVC?

Crosses anterior to both

21

What is Rovsing's syndrome?

Pain caused from compression of the aorta & IVC by the horseshoe kidney

22

There is an increased incidence of which tumor with horseshoe kidney?

Wilm's tumor (2-8x)

23

Other than Rovsing's syndrome and increased tumor incidence, what are two other complications of horseshoe kidney?

1. Dilation of pelvis/calyces --> Uteropelvic junction obstruction

2. Stasis leads to nephrolithiasis

24

In crossed ectopic kidney, what % of the ectopic kidney is fused to the normally situated kidney?

90%

25

How do the ureters fuse in a crossed ectopic kidney?

Normally. They are not ectopic. Normal trigone.

26

What side is crossed ectopic kidney more common? And which gender is it more predisposed to occur in?

Right 3x M/C

M/C in males

27

What complications occur with crossed ectopic kidney?

- obstruction
- stasis
- urinary tract calculi
- infection
- reflux

28

What is the M/C/C of cystic disease in infants?

multicystic dysplastic kidneys

29

What is the 2nd M/C/C of abdominal mass in neonate?

multicystic dysplastic kidneys

30

What are the symptoms of multicystic dysplastic kidney when bilateral?

In infants, causes death from pulmonary hypoplasia.

31

What is a donut kidney?

upper and lower poles fuse in a ring-like fashion

32

What is pancake (or lump) kidney? Where is it located and what are the symptoms?

Fusion of upper & lower poles, w/ pelvis facing anteriorly.

Usually midline & presacral.

Asymptomatic

33

Name 4 different types of renal positional anomalies.

1. Malformation
2. Renal ectopy
3. Nephroptosis
4. Intrathoracic kidney

34

What is the M/C location for renal ectopia?

Presacral (intrapelvic/prevertebral kidney)

35

What is the blood supply for an ectopic kidney?

Renal artery

36

What is nephroptosis, who does it happen to and what side is more common?

Excessively mobile kidney with a redundant ureter.

M/C in females on right side.

37

What complications can arise with nephrotosis?

Deetle's Crisis: renal colic (pain that comes in waves) from kinking of a positionally redundant ureter.

38

What is intrathoracic kidney?

Herniation of the LEFT kidney through the foramen of Bochdalek.

M/C in males

39

What is the blood supply for an intrathoracic kidney?

abdominal aorta

40

What is the M/C/C for a palpable abdominal mass in a neonate?

Hydronephrosis d/t ureteropelvic junction obstruction.

41

What % ureteropelvic junction obstruction are unilateral and what side is it M/C on?

70-90%

LEFT

42

What are some causes for ureteropelvic junction obstruction?

a. ureteral hypoplasia
b. abnormal insertion of ureter into renal pelvis
c. secondary scarring from stones, infection, instrumentation or neoplasm

43

What is Gensinger's rule?

A separate blood supply, ureter & insertion is needed to define a duplex kidney.

44

What % of duplex kidneys are unilateral and what gender are they common in?

75%

Females

45

What is the M/C type of ureter insertion in a duplex kidney?

Incomplete -- ureters join along their course and insert normally on bladder.

46

What is the Weigert-Meyer Law in reference to complete duplex kidney/ureter?

The ectopic ureter inserts INFERIORLY & MEDIALLY in relation to the ureter draining the lower moiety.

47

What complications occur with duplex kidneys?

a. Reflux (M/C)
b. Ureterocele

48

What is the imaging of choice for visualizing primary vesicoureteral reflux?

voiding cystourethrography

49

What is a megaureter and what is the M/C gender and location?

- the distal ureter diameter >7mm
- usually bilateral
- absence of obstruction or reflux
- males
- left sided

50

Ectopic ureteral insertions M/C occur in whom?

females (x6)

51

Where in reference to the external urethral sphincter does an ectopic ureter insert in females? In males?

Females --> after the urethral sphincter; continual dribbling

Males --> before the urethral sphincter; no dribbling

52

The presence of a ureteral jet phenomenon excludes the possibility of which condition?

Significant vesicoureteral reflux

53

What is a retrocaval ureter and what side is it predominately found on?

Right sided ureter runs behind the inferior vena cava

54

What's the M/C complication of a retrocaval ureter?

obstruction

55

What is a ureterocele? What are the two types?

Focal dilation submucosal portion of distal ureter d/t absence of outer muscular layer causing inherent weakness in that area.

Simple (orthotopic) and Ectopic

56

What is the difference between simple and ectopic ureterocele?

Simple = congenital prolapse; normal insertional site
M/C in males & unilateral

Ectopic = does not terminate in the normal position on the trigone.
M/C in females (7x)

57

What is the ratio of simple to ectopic ureterocele?

4-5x ectopic M/C

58

What are two radiographic signs associated with simple ureteroceles?

Spring onion --> small ureterocele
Cobra head --> large ureterocele

59

What is ectopic ureteroceles associated with?

50% have vesicoureteral reflux
50% have stenotic orifices that do not reflux (cuases hydronephrosis)

60

What is a pseudoureterocele and what is it associated with?

Stone impacted in distal ureter producing a zone of edema.

Most often caused by transitional cell carcinoma of bladder or carcinoma of cervix.

61

If the median umbilical ligament doesn't form, the connection between the bladder and umbilicus is called?

urachus

62

What is the M/C ureteral anomaly?

Congenital obstruction of the ureter (M/C at urteropelvic junction)

63

What is the classic triad of Prune-Belly Syndrome?

1. Deficient/absent abdominal muscles
2. Cryptochordism
3. Urinary tract abnormalities (eg. vesicoureteral reflex, urachus, bladder diverticula etc.)

64

What plain film finding may you see with Prune-Belly Syndrome?

Widening/absence of pubic symphysis & bulging of flanks

65

What is an aka for Prune-Belly Syndrome?

Eagle-Barrett syndrome

66

What is the M/C nephrolithiasis forming material?

Calcium oxalate 75-80% (calcium phosphate & calcium urate next most common)

67

What is the M/C location for stone lodging? What are two other common locations?

1. Ureterovesicular junction

Other: ureteropelvic junction & pelvic brim as ureter crosses into pelvis

68

What is the M/C complaint of a renal stone?

Renal colic

69

What is the M/C/C for stone formation by calcium oxalate?

Idiopathic hypercalciuria (85%)

70

Which stone forms in the presence of a UTI (most particularly Proteus)?

Magnesium ammonium hexahydrate (struvite)

2nd M/C type of stone (15-20%)

71

Which type of stone is involved in a staghorn calculi?

Calcium magnesium ammonium phosphate (triple phosphate).

The M/C component of a staghorn calculus is Struvite apatite.

72

Which stones are lucent radiographically?

Uric acid & xanthines

73

Which type of stone is associated with AIDS patients?

Indinavir stones

74

Which stones have soft tissue density on both plain films and CT?

Indinavir stones

75

What % of urinary tract calculi are radiopaque?

90%

76

What is the method of choice for evaluation of acute flank pain?

CT non-contrast

77

Bladder stones are M/C which type of stone?

Uric acid stones

78

Fluid-fluid level seen in the parenchyma of the kidney is most likely what?

renal milk of calcium

79

What are the 2 types of nephrocalcinosis and which is more common?

1. Medullary nephrocalcinosis (95%)
2. Cortical nephrocalcinosis (5%)

80

What is the radiographic sign seen with cortical nephrocalcinosis?

Tram lines -- parallel calcific tracks

81

What are the M/C etiologies of cortical nephrocalcinosis? List 4.

1. Chronic glomerulonephritits
2. Renal chronic necrosis
3. Alport's syndrome (hereditary nephritis & nerve deafness)
4. Transplanted kidney: chronic rejection

82

What is the radiographic features of medullary nephrocalcinosis?

- Bilateral
- Renal pyramids involved
- Diffuse, fan-shaped clusters (stippled or punctate calcification)

83

What are the causes of medullary nephrocalcinosis?

1. Primary hyperparathyroidism (40%)
2. Tubular acidosis (20%)
3. Medullary sponge kidney (20%)
4. Milk-alkali syndrome
5. Hypervitaminosis D
6. Hypercalcemic/hypercalciuric states

84

What is the M/C bacterial infection in humans (of all ages)?

UTIs

85

What is the M/C group of bacteria to causes UTI?

Coliform bacteria (eg. E.coli)

86

What is the M/C type of renal disease?

Acute pyelonephritis

87

What is the M/C/C of acute pyelonephritis?

Vesicoureteral reflux

88

Gas found in the collecting system is indicative of which condition?

Emphysematous pyelonephritis

89

What 2 organisms are M/C associated with emphysematous pyelonephritis?

E.coli & proteus

90

Emphysematous pyelonephritis is M/C seen in what pop'n?

Diabetics

91

What is the etiology of chronic pyelonephritis?

Previous inflammatory process (eg. sarcoidosis, Wegener's etc.)

92

What is the M/C/C of chronic pyelonephritis in children?

Vesicoureteral reflex of infected urine

93

What is the 1st radiographic sign of pyelonephritis?

loss of renal parenchyma

94

What is the modality of choice for a renal abscess?

CT

95

What pop'n of individuals more commonly have renal abscesses?

Immunocompromised or diabetics

96

What is the M/C organism involved in a xanthogranulomatous pyelonephritis?

Proteus

97

What is the classic triad associated with xanthogranulomatous pyelonephritis?

1. Staghorn calculus
2. Absent/diminished excretion of contrast
3. Poorly defined renal mass

98

What is renal papillary necrosis?

Infarction of the papilla BILATERALLY in FEMALES d/t an underlying cause.

99

What is the M/C/C of renal papillary necrosis?

Diabetes

100

Other than diabetes, what are some other causes for renal papillary necrosis?

ADIPOSE (Chapman) or POSTCARDS (ExpertConsult)

A analgesics
D diabetes
I infants in shock
P pyelonephritis
O obstruction
S sickle cell anemia
E ethanol

P pyleonephritis
O obstruction
S sickle cell anemia
T tuberculosis
C cirrhosis
A analgesics
R renal vein thrombosis
D diabetes
S systemic vasculitis

101

What are the named radiographic signs associated with renal papillary necrosis?

1. Lobster claw sign --> streaking of contrast on both sides of fornix along long axis of papilla
2. Ring sign --> contrast making a moat around necrotic papilla
3. Signet ring --> ring sign with pooling of contrast also in papilla

102

What is the cause for bilateral hemorrhagic necrosis?

Hemorrhagic complication of pregnancy

103

What condition does galloping consumption refer to?

Renal TB

104

What is end-stage of TB called and what does it look like?

Putty kidney --> extensive parenchymal calcification

Kidney is autonephrectomized.

105

What is the 1st, 2nd and 3rd M/C location for an echinococcal cyst?

1st = liver
2nd = lungs
3rd = muscles

106

What % of echinococcal cysts calcify?

50-80%

107

Fungus balls "mycetomas" M/C occur in which condition?

Renal candidiasis

108

What is the classical triad of Goodpasture's Syndrome?

1. Glomerulonephritis
2. Pulmonary hemorrhage
3. Iron deficiency anemia

109

What is the M/C form of renal trauma?

Blunt trauma (80%)

110

What is the imaging modality of choice for renal trauma?

CT w/ contrast

111

Ureteral injuries are rare, but when they occur, what is the most likely mechanism?

Penetrating injuries

112

Benign vs. malignant tumors is not a diagnosis for IVP. What is better modality?

Angiogram -- benign tumors are avascular (except hemangioma)

113

What is the M/C grade of kidney injury and by what %?

Grade 1 (80%) -- simple renal contusion

114

What are the two tissue types for benign renal tumors?

Epithelial & mesenchymal

115

What is the M/C benign epithelial renal tumor?

Adenoma

116

What is the upper size limit of a benign renal adenoma before its suspected to be malignant? What is the malignant tumor that must be ruled out when greater than this size?

3cm; renal cell carcinoma

117

Which renal tumor has the highest rate of all tumors to induce osteomalacia?

Hemangiopericytoma

118

What is the condition associated with hemangiopericytoma and a juxtaglomerular tumor?

Dorland's dictionary

119

Which of the two renal tissue origins is more common for benign tumors? Epithelial or mesenchymal?

Mesenchymal

120

What is the M/C benign tumor of the kidney?

Hamartoma/Angiomyolipomas

121

What is the most frequent location for a renal hemangioma?

Apex renal pyramids

122

Renal hemangiomas are M/C unilateral or bilateral?

Unilateral (99%)

123

Tumors of the juxtaglomerular apparatus causes what clinical symptoms and why?

Causes moderate to severe hypertension b/c the tumor secretes renin.

124

What is the M/C tumor renal medulla?

Fibroma

125

Renal hamartomas are M/C unilateral or bilateral?

Unilateral (80%)

126

Bilateral hamartomas are M/C associated with which condition?

Tuberous sclerosis

127

What % of tuberous sclerosis have angiomyolipomas?
What % of patients with angiomyolipomas have tuberous sclerosis?

80%
40%

128

What is the M/C benign FETAL renal neoplasm?

Congenital Wilms' tumor (mesoblastic nephroma)

129

Which benign renal tumor can be indistinguishable from RCC on all imaging modalities?

What is the classic radiographic appearance of this tumor?

Oncocytoma -- should be biopsied

Central stellate scar!

130

Which phakamatosis is associated with bilateral renal cell carcinoma (50%) or multiple renal adenomas?

Von-Hippel Lindau (retino-cerebellar angiomatosis)

131

What are the 4 M/C abdominal masses in infancy?

1. Hydronephrosis
2. Multicystic Dysplastic Kidney (MCDK)
3. Neuroblastoma
4. Wilms

132

With malignant renal tumors, calcification represents increased risk of malignancy when it is: a) peripheral or b) non-peripheral?

Non-peripheral (87%)

133

What is the M/C malignant renal tumor?

Renal cell carcinoma

134

Renal cell carcinoma is M/C unilateral or bilateral?

Unilateral

(Remember, bilateral renal cell carcinomas -- associated with von Hippel Lindau disease)

135

By which route is renal cell carcinoma most likely to metastasize?

Via venous system

136

What is the classic clinical triad associated with renal cell carcinoma? What % of patients have this triad?

Triad (15%)
a. pain
b. hematuria
c. palpable mass

Normally, this tumor is clinically silent until it grows really large & metastasizes.

137

RCC often metastasizes to what organ?

Lung > lymph node > liver > bone

138

What is Page kidney?

Phenomenon of developing hypertension following compression of the renal parenchyma from supcapsular renal collections (eg. hematoma, seroma, urinoma).

Compression results in decreased blood flow which then activates the renin-angiotensin system.

139

What is the M/C renal neoplasm of infancy?

Wilms' tumor

(May be the M/C abdominal neoplasm of infancy too but controversy with neuroblastoma.)

140

What % of Wilms' tumor calcify?

Rare 10% (compared to neuroblastoma = 90%)

141

List 3 syndromes often associated with Wilm's tumor.

1. WAGR Syndrome - Wilm's tumor, Aniridia, Genitourinary syndromes & mental retardation

2. Deny-Drash Syndrome - gonadal dysgenesis (male pseudohermaphroditism) & nephropathy

3. Beckwith-Wiedemann Syndrome - enlargement of body organs, bilateral Wilms' tumor (10%)

142

What's the M/C cell type for renal lymphoma? What's the 2nd M/C cell type?

1st = Non-Hodgkin's lymphoma
2nd = Burkitt's lymphoma

143

What is the M/C retroperitoneal sarcoma?

Liposarcoma

144

90% of all renal pelvis carcinomas are which ones?

transitional cell carcinoma

(remainder 10% is squamous cell)

145

The M/C location for transitional cell carcinoma is?

Bladder

146

What radiographic appearance describes the ureter if transitional cell carcinoma is present?

Champagne glass (or goblet cell)

147

What % of the pop'n has an accessory renal artery? And where on the kidney is the M/C location?

30% upper pole

148

What is the M/C cause for a renal arteriovenous fistula?

acquired through percutaneous biopsy

149

Renal disease is the cause for what % of all hypertension?

3%

150

What is the M/C/C of splenic hypertension?

Atherosclerosis (60-65%)

151

Atherosclerosis of the renal artery is M/C on which side and occurs where specifically in the renal artery?

Left side

Occurs proximal 1/3rd of renal artery OR within first 2cm of renal arteries.

152

What is the 2nd M/C/C of renal hypertension?

Fibromuscular dysplasia (30-35%)

153

What is the M/C/C of renal hypertension in children?

Fibromuscular dysplasia

154

What radiographic sign is associated with renal hypertension?

String of beads

155

What side and which gender does splenic artery involvement in fibromuscular dysplasia most commonly affect?

Right side (75%) and females

156

What condition causes necrotizing vasculitis of the smaller & medium sized arteries (M/C renal & hepatic arteries)

Polyarteritis nodosa

157

What is the M/C/C of renal artery occlusion?

Embolism

158

What are the general underlying causes of renal vein thrombosis in both adults and children?

Dehydration, abnormalities in clotting system or kidney itself

159

What is the M/C/C of renal vein thrombosis in an adult?

membranous glomeruonephritis

160

What is the M/C/C of renal vein thrombosis in a child?

acute enteritis (acute inflammation of the s. bowel)

161

Where is the M/C location for a renal artery aneurysm?

2/3rds at bifurcation of renal artery

162

Calcified aneurysms are _____________ (more or less) likely to rupture.

Less

163

What % of renal artery aneurysms are bilateral?

20%

164

What is the 2nd M/C/C of abdominal mass in a neonate?

multicystic dysplastic kidney (MCDK)

165

What is the relationship between multicystic dysplastic kidney and the collecting system?

The cysts DO NOT communicate with the collecting system.

166

Infantile Polycystic Kidney Disease is now known by which name?

Autosomal recessive polycystic kidney disease

167

What is the prognosis/function of the kidneys involved in multicystic dysplastic kidney if it is unilateral? Bilateral?

Unilateral = no renal function; 65% of cases regress in children.

Bilateral = lethal

168

What are the two types of multicystic dysplastic kidney?

1. Pelvoinfundibular atresia = M/C
- no renal function
- no renal sinus, pelvis, or parenchymal tissue
- atresia of ureter & renal pelvis
2. Hydronephrotic-obstructive
- dominant cyst present in the renal pelvis

169

Is autosomal recessive polycystic kidney disease unilateral or bilateral? What is their relationship to the collecting system?

Bilateral symmetrical

Communicate with the collecting system

170

Adult polycystic kidney disease is now known as?

Autosomal dominant polycystic kidney disease

171

Is autosomal dominant polycystic kidney disease unilateral or bilateral? What is their relationship to the collecting system?

90% bilateral asymmetrical

Non-communicating cysts

172

List 3 co-existing conditions that occur with autosomal dominant polycystic kidney disease.

1. Colon diverticula 80%
2. Liver cysts (60%) & Pancreas cysts (10%)
3. Caroli's disease

173

List 3 complications of autosomal dominant polycystic kidney disease.

1. Renal failure 35-48%
2. Berry aneurysm 15-20%
3. Hypertension
4. Increased incidence renal cell carcinoma? (questionable!)

174

What is one way to help detect the difference between autosomal dominant polycystic kidney disease and multiple simple renal cysts?

Look for extrahepatic cysts! (eg. Liver)

175

Which is more common: ARPKD or ADPKD?

ADPKD

176

What does ARPKD have an association with?

Hepatic fibrosis
Caroli's disease

177

What are the features of medullary sponge kidney?

- Medullary cysts caused by dilatation of distal collecting ducts
- Communicating
- Self-limiting
- No renal function impairment
- Predisposed to calculus formation

178

What pop'n is medullary sponge kidney seen in?

Young adults

179

What % of medullary sponge kidney cases bilateral?

75%

180

What is the difference between uremic sponge kidney and medullary sponge kidney?

Uremic sponge kidney occurs in a younger pop'n and results in severe normochromic anemia.

181

What is a parapelvic cyst? What is a peripelvic cyst?

Parapelvic cyst = cyst off parenchyma extending into hilum
Peripelvic cyst = cyst arising in renal hilar itself

182

What is the M/C/C for hydronephrosis?

stone formation

183

List 4 types of hydronephrosis?

1. Congenital, Non-obstructive (Functional eg. congenital megaureter, diabetes insipidus)
2. Congenital, Obstructive (Mechanical eg. positional anomalies of the ureter)
3. Acquired, Non-obstructive (eg. spinal cord trauma)
4. Acquired, Obstructive (eg. stones, tumors)

184

Where are 3 normal constrictions of the ureter?

1. Ureteropelvic junction
2. Pelvic brim @ point ureter crosses over external iliac crest (L5/S1)
3. Ureterovesicular junction

185

What is the name of the inflammatory condition where small cysts arise along the ureteral wall?

Ureteritis cystica (or Pyeloureteritis cystica)

186

What is Potter's syndrome?

Bilateral atresia of ureters. Incompatible with life.

187

What is the M/C benign tumor of the ureter?

Benign fibrous polyps

188

What is the M/C malignant tumor of the ureter?

Transitional cell carcinoma (95%)

189

Where is the M/C location of a ureteral diverticula?

Proximal or distal third

190

What is the M/C/C of ureter infection?

vesicoureteral reflux

191

What is the 2nd M/C/C of ureter infection?

Obstruction

192

What tissue cells line the bladder?

Transitional epithelium

193

What is the M/C congenital anomaly of the bladder?

Exstrophy (or epispadias)

194

What is exstrophy?

Deficiency in development of lower abdominal wall musculature. Mucosa of the bladder is continuous with the skin.

195

What is the radiographic findings associated with exstrophy?

Hurley-stick ureter (dilation of distal ureter)
and
Manta ray sign (widened pubic symphysis)

196

What is the radiographic appearance of a bladder duplication?

M/C incomplete

Can have a vertical septum.
Can have a horizontal septum --> "hour-glass bladder"

197

What causes a pear shaped bladder?

Circumferential compression of the bladder d/t accumulation of fluid (either blood or urine) in the loose tissues surrounding the bladder.

198

What is the M/C/C of pear-shaped bladder?

Trauma

199

A Christmas tree/pine tree bladder can be seen in which condition?

Neurogenic bladder (eg. paraplegia, diabetes, syringomylia)

200

Which bladder condition has gas in the wall?

Emphysematous cystitis

201

What condition will most likely cause calcification along the bladder wall and ureter?

Schistosomiasis

202

There is an increased incidence of what condition with schistosomiasis?

Squamous cell carcinoma

203

What is the M/C benign tumor of the bladder?

Papilloma/Fibrous Polyp

204

What is the 2nd M/C malignant tumor of the bladder?

Adenocarcinoma (old theory) or Squamous cell carcinoma (recent books)

205

What is the M/C/C of external bladder obstruction in males?

Benign prostatic hypertrophy

206

What is the M/C/C of retroperitoneal fibrosis?

Idiopathic (70%) -- called Ormond's disease

207

Where is the M/C location for retroperitoneal fibrosis?

Around the aorta and common iliac arteries (the fibrosis encases the aorta and may extend to the IVC and ureters).

208

What is the M/C retroperitoneal tumor?

Metastasis

209

What is the M/C primary retroperitoneal tumor?

Liposarcoma

210

What is the only retroperitoneal malignant tumor to calcify?

Malignant teratoma

211

What is the M/C/C of retroperitoneal hematoma/hemorrhage?

Rupture of AAA

212

What is the 2nd M/C/C of retroperitoneal hemorrhage?

Disease of the adrenal glands/kidneys

213

What is the imaging of choice for retroperitoneal bleeding?

CT

214

Corticosteroids and androgens are secreted from which portion of the adrenal glands?

Cortex

215

What is secreted from the adrenal medulla?

epinephrine

216

What is the M/C/C of calcification of the adrenal glands?

Hemorrhage associated with birth trauma

217

What is Cushing's syndrome?

Excess glucocorticosteroids (either endogenous or exogenous)

218

What is Addison's disease?

Adrenal hypofunction from primary (eg. tissue destruction of adrenal gland) or secondary (eg. inadequate stimulation by ACTH) causes.

219

What is the M/C/C of Addison's disease in US?

Idiopathic

220

What is another source of adrenal gland destruction other than idiopathic?

Granulomatous disease (usually TB)

221

Other than hemorrhage, what are some other causes for adrenal gland calcification?

TB & addison's (infrequently)

222

What is the M/C location for a neuroblastoma?

adrenal glands (30-50%)

223

Pheochromocytoma is a vascular tumor of which cells?

chromaffin cells

224

Where within the adrenal gland does pheochromocytoma M/C occur?

medullary (90%)

225

What is the main clinical sx associated with pheochromocytoma?

hypertension

226

What is the rule of 10s with pheochromocytoma?

10% bilateral
10% extra-adrenal
10% malignant
10% familial
10% calcification
10% do not have hypertension
10% in children

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What is a ganglioneuroma?

Benign, asymptomatic tumor composed of mature ganglion cells & schwann cells.

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What this M/C malignant tumor of the urethra?

squamous cell carcinoma (80%)

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What's the DDx of a single enlarged kidney without any lesions, normal calyces and pelvis.

1) Acute glomerulonephritis (rarely unilateral)
2) Unilateral renal vein thrombosis
3) Infiltration by lymphoma & leukemia

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What's the DDx of a bilateral enlarged kidney without any lesions, normal calyces and pelvis.

1) Acute glomerculonephritis
2) Inferior vena cava thrombosis or bilateral renal vein thrombosis
3) Bilateral infiltration by lymphoma or leukemia

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Which conditions are pheochromocytoma associated with?

NF & von Hippel-Lindau & MEN type II

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What is the M/C/C of calcification in the bladder?
What is another cause?

Schistosomiasis

2nd cause = tuberculosis

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What are 4 syndromes most commonly associated with multiple renal cysts?

1) Adult polycystic kidney disease
2) von Hippel-Lindau syndrome
3) acquired renal cystic disease (from dialysis)
4) tuberous sclerosis