Vascular disease

Question 1

At what level do the renal arteries branch off the aorta?

Answer 1

L1 - L2

Question 2

What are the two main branches and what do they supplu in the kidney?

Answer 2

Ventral - anterior, superior

Dorsal - posterior, inferior

Question 3

What is brodels line? Why is it significant?

Answer 3

Avascular plane between the ventral and dorsal arteries

Preferred site for placing PCN

Question 4

What is the pathway of arterial flow in the kidney?

Answer 4

Renal -> rami -> segmental -> interlobar -> arcuate

Question 5

What is the difference in drainage vessels between the right and left renal vein?

Answer 5

Right doesnt have the inferior phrenic and gonadal, they drain directly to IVC

Question 6

Which side are varices/varicoceles more common?

What is the proposed mechanism?

Answer 6

Left

Anatomic anomaly between the SMA and Aorta

Question 7

Enlarged left gonadal vein should prompt search for what condition?

Answer 7

Nutcracker phenomenon - left renal vein between SMA and aorta

Question 8

Where are the two types of circumcaval ureters?

Answer 8

1 - lateral border of psoas

2 - lateral border of IVC

Question 9

What is the renal involvement in polyarteritis nodosa?

Answer 9

Hema/proteinuria, renal ischemia, renin mediated hypertension

Parenchymal scarring and aneurysms are the main finding

aneurysms of the SMALL arteries are classic

Question 10

What are the associations with polyarteritis nodosa?

Answer 10

RA, Sjogrens, HBV, cryoglobulinemia, hairy cell leukemia

Question 11

What is the age for wegeners? What are the symptoms?

What are the radiologic manifestations?

Answer 11

30-40s, male

Upper airway disease (sinusitis), pulmonary involvement, can have RPGN

microaneurysms, renal infarction, parenchymal scarring, hemorrhage

Question 12

What is the renal involvement of SLE

Answer 12

small vessel microaneurysms, small renal infarcts

Question 13

What is the renal invovlement of scleroderma?

Answer 13

Narrowing of interlobular arteries due to intimal thickening

Absence of microaneurysms

Question 14

What is the appearance of benign nephrosclerosis? malignant?

Answer 14

Shrunken kidneys with irregular cortical thinning

Shrunken kidneys, can see tortuosity and rapid tapering of intrarenal arteries

Question 15

What is the capsular rim sign?

Answer 15

Capsular arterial perfusion remains intact with a renal artery infarct

Question 16

What is the most common cause of renal artery aneurysm?

Answer 16

Atheroscelrosis

Question 17

Where are mycotic renal aneurysms located?

Answer 17

At branch points of arteries or taperings

Question 18

What is the most common cause of renal AVM?

Answer 18

Renal biopsy

Question 19

What is the appearance of a renal AVM?

Answer 19

Enlarged supplying artery +/- collaterals
=/- retrograde flow in distal vessel
Enlarged draining veins +/- atherosclerosis

Question 20

Which side is renal vein thrombosis more common?

What is the most common cause?

Answer 20

Left

Membranous glomerulonephritis

Question 21

What are the causes of renal vein thrombosis

Answer 21

Extension of tumor (RCC, adrenal)
Dehydration
Extrinsic compression
Trauma
Thrombocytosis
Pancreatitis
Membranous glomerulonephritis (most common)

Question 22

Nonenhancement of the kidney that has arterial flow suggests what?

Answer 22

Renal vein thrombosis

Question 23

Which side is gonadal vein thrombosis more common? Who gets it?

Answer 23

Postpartum women

Left is spared by reflux of blood into the gonadal vein

Question 24

Who gets ovarian vein thrombosis?

Answer 24

Post TAH or BSO

Question 25

What is renal lymphangiomatosis?

Answer 25

Lymphatic tissue fails to develop a normal communication with rest of lymphatic system, leading to development of perinephric cysts