Renal and Urological Imaging

Question 1

most common cause of renal colic?

Answer 1

ureteric calculus

Question 2

calculi are most easily seen on ___

Answer 2

CT

Question 3

conditions of what systems can stimulate renal colic?

Answer 3

gynae

renal eg pyelonephritis

Question 4

what imaging should you do if you suspect pyelonephritis as the cause of renal colic and why?

Answer 4

USS, excludes ureteric obstruction

Question 5

1st line imaging test for a suspected renal calculus

Answer 5

KUB x ray

Question 6

why do you commonly get 2 x rays for the ureters?

Answer 6

need abdo and pelvic as they are long and extend out of view

Question 7

what part of the spine do the ureters pass in front of?

Answer 7

lumbar transverse processes

Question 8

what muscles do the ureters pass inferiorly to?

Answer 8

psoas muscles

Question 9

what are you looking for on imaging of the ureters?

Answer 9

strictures
filling defects
displacement of calices

Question 10

what actually is an IV urogram?

Answer 10

x ray taken following an injection of contrast

Question 11

other causes of calcification in the abdomen that can pose as a urinary tract calculus?

Answer 11

phleboliths
mesenteric lymph nodes
vascular calification
uterine fibroids (usually bigger)

Question 12

is contrast used in a CT looking for kidney stones?

Answer 12

no

Question 13

CT should be avoided in which patients in particular?

Answer 13

pregnant women (esp 1st trimester)
young women in general

Question 14

most calculi pass spontaneously: T or F

Answer 14

T

Question 15

macroscopic haematuria is an uncommon disease: T or F

Answer 15

F, quite common

Question 16

what kidney tumour is prevalent in all ages?

Answer 16

renal cell carcinoma

Question 17

what tumour of the urinary tract is found in people over 45?

Answer 17

transitional cell carcinoma

Question 18

what does a cystoscopy look at?

Answer 18

bladder and urethra

Question 19

what does CT urography look at?

Answer 19

kidneys
collecting systems
ureters

Question 20

why do we not use a contrast CT when looking for stones?

Answer 20

can mask stones as the contrast is white (stones show up white too)

Question 21

lots of contrast is good for looking at what structures of the urinary system?

Answer 21

renal parenchyma

tumours

Question 22

1st line investigation for >50 with haematuria?

Answer 22

CT urogram

Question 23

1st line investigation for <50 with haematuria?

Answer 23

USS kidneys

cystoscopy

Question 24

when is the only time you would do a CT urogram in <50s with haematuria?

Answer 24

when USS and cystoscopy are normal but haematuria persists

Question 25

when would you do MR urography on a patient?

Answer 25

when CT urogram is contraindicated only (eg pregnancy, contrast allergy, renal impairment)

Question 26

it is extremely uncommon for renal tumours under _cm to metastasise

Answer 26

2cm

Question 27

what is an angiomyolipoma?

Answer 27

renal mass containing fat (benign)

Question 28

Tx of angiomyolipoma?

Answer 28

follow up only to check for bleeding

Question 29

solid masses larger than 4cm are often malignant T or F

Answer 29

F, >3cm

Question 30

what investigation is 1st line for cyst diagnosis?

Answer 30

USS

Question 31

what Ix is used to stage a malignant renal tumour?

Answer 31

CT

Question 32

areas of metasases from kidney?

Answer 32

lung | bone

Question 33

pre-renal causes of renal impairment?

Answer 33

dehydration hypotension renal artery stenosis

Question 34

renal causes of renal impairment?

Answer 34

parenchymal disease drugs toxins

Question 35

post renal causes of renal impairment?

Answer 35

obstruction

Question 36

hydronephrosis often accompanies ___

Answer 36

obstruction

Question 37

Ix for pre-renal disease?

Answer 37

MR angiography to detect renal artery stenosis

Question 38

Ix of direct renal disease?

Answer 38

USS

Question 39

the testis is typically hypovascular on USS in epididymoorchitis T or F

Answer 39

F, it is hypervascular

Question 40

the testis is typically avascular on USS in testicular torsion T or F?

Answer 40

T

Question 41

causes of painless scrotal swelling?

Answer 41

hernia varicocele hydrocele epididymal cyst (v common)

Question 42

varicocele commonly presents on what side?

Answer 42

left

Question 43

what does hydrocele look like on USS?

Answer 43

black fluid around testicle

Question 44

what part of the epididymis does a cyst usually arise on?

Answer 44

epididymal head

Question 45

an intratesticular soft tissue mass is called?

Answer 45

testicular seminoma

Question 46

renal trauma injury is best assessed by?

Answer 46

CT

Question 47

is extra or intraperitoneal rupture of the bladder more common?

Answer 47

extra

Question 48

how is extraperitoneal bladder rupture treated?

Answer 48

conservatively

Question 49

how is intraperitoneal bladder rupture treated?

Answer 49

surgery

Question 50

how is bladder trauma diagnosed?

Answer 50

cytography

Question 51

what kind of trauma causes urethral disruption?

Answer 51

ant pelvic fracture | straddle injury

Question 52

Tx for ureteric obstruction?

Answer 52

nephrostomy | ureteric stent