renal imaging

Question 1

decr in intensity of x-ray beam caused by absorption of photons in tissue

Answer 1

attentuation

Question 2

the change in density of a tissue following admin of IV contrast

Answer 2

enhancement

Question 3

hounsfield unit of -1000

Answer 3

air

Question 4

hounsfield unit of -120

Answer 4

fat

Question 5

hounsfield unit of 0

Answer 5

water

Question 6

hounsfield unit of +40

Answer 6

muscle

Question 7

hounsfield unit of +400

Answer 7

bone/Ca

Question 8

lack of echoes b/c a structure lacks internal acoustic reflectors (ie cysts are black)

Answer 8

anechoic or sonolucent

Question 9

when an ultrasound beam passed thru fluid, the intensity of the sound nrg is not diminished

Answer 9

enhanced thru transmission

Question 10

1st line of imaging test in patients with unexplained hematuria or renal dysfxn

Answer 10

U/S

Question 11

what is the major method of imaging in characterizing cystic and solid renal lesions?

Answer 11

CT

Question 12

the portion of the cortex that forms the base of the lobe is____

Answer 12

centrilobular

Question 13

the portion of the cortex that surrounsd the sides of the medulla is called the ______

Answer 13

septal cortex

Question 14

most kidneys are position b/w the ______lumbar vertebrate

Answer 14

1st & 3rd

Question 15

phrase for the perinephric space bounded by the anterior and psoterior renal fascia

Answer 15

gerotas fascia

Question 16

what radiographic imaging is most sensitive for evaluating flank pain

Answer 16

CT

Question 17

most common cause of flank pain

Answer 17

renal stone disease

Question 18

gold standard for imaging of flank pain

Answer 18

non contrast enhanced helical CT

Question 19

msot direct sign of ureteral calculus?

Answer 19

visualization of the calculus of the ureter

Question 20

most common renal mass seen on U/S

Answer 20

simple cyst

Question 21

incidental adreanl mass discovered on an imaging study obtained for other reasons

Answer 21

incidentaloma

Question 22

most adrenal incidentalomas are benign or malignant

Answer 22

benign

Question 23

recommedned f/u for adrenal incidentaloma 3-5 cm

Answer 23

surgery vs f/u vs other imaging

Question 24

what are the high risk malignancies for adrenal incidentaloma?

Answer 24

breast, lung, melanoma

Question 25

excessive excretion & precipitationg of salts in urine or a lack of inhibiting substances

Answer 25

urolithiasis

Question 26

urolithiasis is more common in

Answer 26

men, older, non-Af Am

Question 27

rim of tissue around a stone at the impaction site; urethral wall edema

Answer 27

soft tissue rim sign

Question 28

what secondary sign has a high positive perdictive value in patient with acute flank pain

Answer 28

hydroureter and perinephric stranding

Question 29

most cost effective method of defining and confirming benign cyst

Answer 29

U/S

Question 30

CT with HU under 20, no wall enhancement,no calcification of nodularity

Answer 30

simple cyst

Question 31

what makes a cyst not simple (7)

Answer 31

1. calcification 2. hyperattentuation >20 HF units 3. septations 4. multiloculated 5. nodularity 6. thick wall 7. enhancement

Question 32

U/S with anechoice, no perceptible wall, enhanced thru transmission

Answer 32

simple cyst

Question 33

what class: simple benign cyst with thin walls, no septa or calcifications

Answer 33

bosniak category 1 cystic mass

Question 34

what class: benign cystic lesions that may contain thin septa with fine linear calcification in walls

Answer 34

bosniak category 2 cystic mass

Question 35

what class: more complex cysts w/ incr #septa, incr calcifcication, thicker, more nodular

Answer 35

bosniak category 2F cystic mass

Question 36

what class: indeterminate masses thick irregular walls or septa with large amt of calcifications

Answer 36

bosniak category 3 cystic mass

Question 37

what class: malignant cystic masses with thick irregular enhancing walls or septa containing small of large amts of Ca

Answer 37

bosniak category 4 cystic mass

Question 38

f/u for bosniak class 1

Answer 38

no imaging f/u

Question 39

fu of bosniak category 2

Answer 39

if larger than 3 cm then f/u

Question 40

most common solid renal mass

Answer 40

renal cell carcinoma

Question 41

____tend to be tumefactive & ____are infiltrative

Answer 41

RCC; transitional cancers

Question 42

if you see a solid round mass, what is it until proven otherwise?

Answer 42

renal cell carcinoma

Question 43

which carcinomas have epicenters in renal sinus (2)

Answer 43

1. transitional cell carcioma | 2. squamous cell carcinoma

Question 44

which carcinomas have epicenters in parenchyma (3)

Answer 44

1. lymphoma 2. infiltrating RCC 3. metastases

Question 45

adrenal mass >6 cm is most likely?

Answer 45

malignant

Question 46

best test for determining whether incidental adrenal mass is adenoma is?

Answer 46

CT with pre & post contrast delayed imaging