Urography/Pyelography

Question 1

the general term for the radiographic examination of the urinary system with the use of a radiopaque contrast media

Answer 1

Pyelography/Urography

Question 2

What are the methods of doing urography?

Answer 2

1. Excretory (Antegrade)
2. Retrograde

Question 3

• in this examination of the urinary system the contrast media is injected into the veins and the contrast medium will move downward
• true functional study
• traveling in the normal excretory direction of flow

Answer 3

Excretory (Antegrade)

Question 4

IV Contrast Media may be administered by either?

Answer 4

1. Bolus Injection
2. Drip Infusion

Question 5

• one in which the entire dose of contrast media is injected into the venous system at one time
• used typically for maximum contrast enhancement

Answer 5

Bolus Injection

Question 6

• introduction of contrast media with the use of catheter or against the flow of blood or gravity.
• in this examination the contrast media is injected
  into the lower canal with the use of catheter and
  the contrast medium will move upward
• non-functional examination of the urinary system

Answer 6

Retrograde

Question 6

• method whereby contrast media is introduced into the venous system via connective tubing attached to the I.V. site

Answer 6

Drip Infusion

Question 6

What are the types of Excretory Urography?

Answer 6

1. Routine pyelography
2. Timed, Minute, Rapid, Hyertensive Pyelography/Urography
3. Drip-Infusion Pyelography
4. Excretory Urethrography

Question 7

• general or common method of examining the urinary tract for non-specific condition of the patient

Answer 7

Routine Pyelography

Question 8

• special method of examining the urinary tract for cases of patient’s with high blood pressure.

Answer 8

Timed, Minute, Rapid, Hypertensive Pyelography/Urography

Question 9

– special radiographic examination of the urinary tract which is done when the ordinary or routine IVP fails to evaluate kidney functions.

Answer 9

Drip-Infusion Pyelography

Question 10

– radiographic examination of the male urethra which is done during the time of micturation or urination.

Answer 10

Excretory Urethrography

Question 11

• x-ray films of the bladder and urethra taken after the bladder is filled with a contrast material and while the patient is expelling urine. .

Answer 11

Voiding Cystourethrography

Question 12

What are the types of retrograde urography?

Answer 12

1. Retrograde Pyelography
2. Retrograde Ureterography
3. Retrograde Cystography
4. Retrograde Urethtograpy (RUG)

Question 13

– radiographic examination of the renal pelvis and calyces, the ureters and bladder with the use of long
catheter and injection of dye in reverse pattern.

Answer 13

Retrograde Pyelography

Question 14

– radiographic examination of the ureters in the reverse pattern.

Answer 14

Retrograde Ureterography

Question 15

– radiographic examination of the urinary bladder with the use of a retention catheter.

Answer 15

Retrograde Cystography

Question 16

– radiographic examination of the male urethra following the injection of a dye in the urethral meatus.

Answer 16

Retrograde Urethrography (RUG)

Question 17

• radiographic procedure in which contrast media is injected intravenously

Answer 17

Excretory Urography or Intravenous Pyelography or Intravenous Urography

Question 18

What are the purpose of the study?

Answer 18

1 To visualize the collecting portion of the urinary system.
2. To assess the functional ability of the kidneys.
3. To evaluate the urinary system for pathology or anatomic anomalies

Question 19

What are the contrast media used?

Answer 19

Iodine-based solution such as Hypaque, Telebrix, Conray, Renografin and oth

Question 20

2 TYPES OF IODINATED CONTRAST MEDIA AVAILABLE
FOR INTRAVENOUS USE

Answer 20

1. Ionic - media whose molecules dissociate into 2 charged particles when place in solution, resulting in higher osmolality
2. Non Ionic:
   - Produce fewer adverse reactions
   - more expensive
   - Media whose molecules remain whole in solution

Question 21

• Flushing of the skin/ temporary hot flash
• Metallic taste in the mouth
• Nausea
• Vomiting
• Few hives or urticaria

Answer 21

Mild Reaction

Question 22

• Exceeding number of hives or giant hives
• Tachycardia

Answer 22

Moderate Reactions

Question 22

* Dyspnea * Sudden hypotension * Loss of consciousness * Cardiac arrest

Answer 22

Severe Reactions

Question 23

abnormal condition of no urine production

Answer 23

Anuria

Question 23

Indication of the study:

Answer 23

1. Ruling out of stones 2. Presence of Inflammation 3. Internal Defects 4. Hydronephrosis 5. Hematuria

Question 24

malignant tumor of cells (called plasma cells) in the bone marrow

Answer 24

Multiple myeloma

Question 25

a disorder of the pancreas that causes an increase in blood glucose levels

Answer 25

Diabetes millitus

Question 26

tumor of the adrenal glands

Answer 26

Pheochromocytoma

Question 27

condition in which the kidneys stop functioning and do not produce urine

Answer 27

Renal Failure

Question 28

Patient Preparation:

Answer 28

1. Light evening meal. 2. Give either 4 dulcolax tablet or castor oil to facilitate evacuation. 3. NPO after midnight. 4. No breakfast and give dulcolax suppository. 5. Report for the examination early in the morning.

Question 29

The patient should void just before the examination is performed for the following reasons:

Answer 29

1. A bladder that is too full could rupture, especially if compression is applied early in the exam 2.Urine already present in the bladder dilutes the contrast media that accumulates there

Question 30

Materials needed for the examination:

Answer 30

1. 30cc of contrast media 2. 18-22 gauge needle (Adult) 23-25 gauge needle (pediatric) 3. 1 ampoule or vial benadryl 4. 2.5 ml syringe 5. 250-500 ml D5W 6. 30 cc syringe 7. 1 Venoset 8. Cold towel 9. Emesis basin

Question 31

What are the projections in Urography?

Answer 31

1. Scout AP Projection 2. Nephrogram/Nephrotomogram 3. 5 minute image AP Projection 4. 10-15 minute image AP Projection 5. 20 minutes Oblique RPO and LPO Position 6. Postvoid AP erect 7. Alternative PA prone

Question 32

Aftercare:

Answer 32

1. Observation for 6 hours. 2. Watch for late contrast reactions. 3. Prevention of dehydration. 4. In high risk patients-renal function tests should be done to watch for deterioration.