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FRCR 2A > Urology > Flashcards

Urology Flashcards

1
Q

Causes of papillary necrosis?

A

POSTCARDS

Pyelonephritis
Obstruction
Sickle cell disease
TB
Cirrhosis
Analgesics
Renal vein thrombosis, renal transplant rejection, radiation
Diabetes –> commonest!
Systemic vasculitides

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2
Q

Associations of medullary sponge kidney?

A

Caroli’s
Ehler’s Danlos
Beckwith-Weidman

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3
Q

Most common testicular tumours in:
- children <10
- 20-30s
- 30s
- 40s
- >50s

Which tumours secrete AFP?

A

Yolk sac tumour + teratoma

Choriocarcinoma

Embryonal cell carcinoma

Seminoma

Lymphoma

Yolk sac, embryonal cell ca and (teratoma)

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4
Q

Types of renal cell ca and their association?

A

Clear cell adeno (most common) - VHL
Papillary
Medullary (rarest) - sickle cell
Chromophobe - Birt Hogg Dube

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5
Q

Bosniak cyst classification
- Class I?
- Class II?
- Class IIF?
- Class III?
- Class IV?

A
  • Simple, <15 HU, no enhancement
  • Hyperdense <3cm, a few thin septations, thin calcifications, no enhancement
  • Hyperdense >3cm; nodular calcifications; apparent but no measurable enhancement of the septa or walls; multiple thin septa
  • Thick wall or septa; measurable mural enhancement; mural nodule - 50% chance of cancer
  • Solid enhancing structure
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6
Q

Von Hippel Lindau
- renal features?
- pancreatic features?
- adrenal?
- CNS?

A
  1. Renal cysts; RCCs
  2. Cysts; serous cystadenoma; pancreatic adenocarcinoma
  3. Phaeochromocytomas
  4. Cerebellar, brainstem and spinal cord haemangioblastoma
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7
Q

Differential for T2 dark renal cyst?

A

Lipid poor AML
Papillary RCC
Haemorrhagic cyst

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8
Q

Some questions on TCC:

  1. Which cancer syndrome is associated with it?
  2. Most common site of TCC?
  3. Site usually involved in ureter TCC?
A
  1. HNPCC
  2. Bladder, followed by renal pelvis, then ureter - bladder is 100 x more common than ureter!
  3. Distal third - 75%
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9
Q

What kind of malignancy is associated with urachal remnant/cyst?

A

Adenocarcinoma

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10
Q

Causes of fistula?

A

Crohn’s
Diverticulitis
Cancer
Certain infections - actinomycosis
Radiation

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11
Q

Some questions on prostate cancer:

  1. Where does most cancer arise?
  2. Appearance on MR?
  3. Important staging point?
  4. Risk stratification of cancer?
  5. Who gets a bone scan?
  6. What sequence is most sensitive for transitional zone cancer?
A
  1. Peripheral zone
  2. Dark on T2, restricts diffusion, enhances
  3. T2 - remains within the prostatic capsule; T3 - extends beyond the capsule
  4. Done on PSA and Gleason score - <10 and <6 is low risk
  5. Patients with intermediate (PSA 10-20 and Gleason 7) or high risk disease (PSA >20 and Gleason 8 or more)
  6. T2 > ADC
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12
Q

On male GU tract (intraprostatic) cysts:

  1. Features of Mullerian duct cysts?
  2. Features of prostatic utricle cysts?
A
  1. Extend beyond the superior border of the prostate; seen in young adults; no communication with urethra
  2. Contained within prostate; communicate with urethra; associated with GU congenital anomalies
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13
Q

On imaging appearance of seminoma:

  1. Appearance on US?
  2. On MR?
A
  1. Homogenous hypoechoic round, may be microcalcification
  2. Homogenously T2 dark
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14
Q

On phaechromocytomas:

  1. Imaging appearance?
  2. Rule of 10s?
  3. Associated syndromes, in order of importance?
A
  1. Very variable. Usually >3cm, CT heterogenous, MR T2 bright “lightbulb” classically. May be haemorrhage, necrosis. No invasion.
  2. 10% extra-adrenal, 10% bilateral, 10% children, 10% non-functioning
  3. VHL; MEN IIa+b; NF1, Sturge Weber, TS
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15
Q

Multiple Endocrine Neoplasia

  1. MEN 1?
  2. MEN 2a?
  3. MEN 2b?
A
  1. 3 Ps: pituitary adenoma, parathyroid hyperplasia, pancreatic tumour (gastrinoma)
  2. 1M, 2Ps: medullary thyroid ca., parathyroid hyperplasia, phaeochromocytoma
  3. 2Ms, 1P: medullary thyroid ca., multiple neuroma, phaeochromocytoma
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16
Q

Adrenal cortical carcinoma:

  1. CT appearance?
  2. MR?
  3. Enhancement characteristics?
A
  1. Large (>6cm), heterogenous, peripheral nodular enhancement; necrosis, calcification; invasive - IVC, liver, diaphragm; there is atrophy of the contralateral gland.
  2. Heterogenous, T1 and T2 bright compared to liver
  3. Enhance strongly, slow wash out

50% of patients have symptoms related to excess hormone production
2 peaks - children and adults in 40s-50s.

17
Q

On bladder cancer:

  • what is the reason for doing MR?
A
  • tells you if there is muscle invasive disease (T2a and b)
18
Q

Absolute washout adrenal?
Abnormal?

A

HU(PV) - HU(delayed)/HU(PV-NC)

> 60% suggestive of adenoma

Cancers hold on to contrast!

19
Q

Relative washout adrenal?

A

HU(PV)-HU(delayed)/HU(PV

> 40% suggestive of adenoma

FRCR 2A (10 decks)

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