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77 Cards in this Set

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  • Back
what are the 2 most common imaging modalities to look at the kidneys an urinary tract
CT and Ultrasound
what do you use a MRI for in the kidneys? 2
used to characterize renal tumors w/o biopsy

also to look at vasculature to see stenosis
if a pt has any of the following, what imaging method should you order:

Flank pain, suspected GU calculus
Abdominal pain, unknown etiology
Follow up known GU calculus
Hematuria
plain Xray
how do you see a renal artery anuerysm?
curvy linear calcification

prob not on test but maybe on boards
what is the first artery to calcify in the body
splenic
what is the psoas stripe (shadow)?
it is the psoas muscle and can show diff paths

this is prob gonna be an xray
3 places you can see a kidney stone (commonly)

***
right as it comes out the uteropelvic junction

pelvic inlet/brim (where they cross iliac vessels)

right before it enters the bladder (ureterovesicular junction)
psoas margin
calculus at UP junction
pain from kidney stones occurs due to?
stone rubbing on urterer
yellow arrows
phleboliths
What is a Pelvic Phlebolith?
Phleboliths are masses, deposits or growths which develop in the wall of a vein and are composed of calcium or lime
what are some of the things you are looking for in xray of the abodmen
Stones bones masses and gasses
what are the Houndsfield numbers for air, water, and fat...

****
water= 0 (up to 20)
air= -1000
fat=small minus (-50ish) any number minus number less than air (even -100!)

also cyst is around -15-20

on CT when you put your mouse over something on the image, it gives you a number. so you can tell what that something is based on the number.. Aka if you put your mouse over something and the number is -40 you would have a fatty cyst
propertoneal fat line distortion
oblique is used on plain film for what
to triangulate where a density is
1. Air
2. Fat (-50)
3. Soft Tissue
4. Calcification
Most often requested to evaluate suspected ureteral obstruction
Intravenous Pyelogram
what is are the 2 types of contrast and which is most common?
ionic

non ionic: more common (more expensive but safer)
if you are allergic to shell fish can you still get IVP
yes!! they used to think not, but you can..

this could show up on the exam
big pro of IVP?
Demonstrates exact level of obstruction
if there is an allergy to contrast, what should be your #1 modality to image the kidney?

***
Ultrasound
all of the following are what?

History of hypersensitivity
Combined renal and hepatic disease
Oliguria
Serum creatinine > 2 mg/ml
Diabetes with renal insufficiency
Glucophage
Multiple myeloma
Contraindications to contrast
Even the smallest calcifications are visible with ____?

***
CT!
what is the most important thing that an ultrasound can show? what is another major benefit?

*You will need to be able to recognize
an ultrasound
Can differential cyst from solid

No radiation
right kidney

can see liver next to it

black is renal cortex

middle is central renal core (can't see collecting structures)
what is shown? what is the sign?

***
Renal cyst (smooth marginated, anechoic (without echoes)
Beak sign: edge of cyst comes up to the cortical margin
what is being shown
a solid
scout for calculus disease use what imaging modality?
Plain film
acute urinary obstruction use what?
IVP
if allergic to iodine or to confirm cyst or to avoid radiation use what imaging modality?
Ultrasound
If information is desired about the renal arteries or if renal diagnosis still unclear use what imaging modality
MRI
excellent and preferred cross sectional anatomy..use what modality?
CT
must know
from top down:

Calyx
Infundibulum
Pelvis
Ureter
what are the 3 causes of filling defects?

*TEST
Stone

Clot

Tumor
IVP shows what 3 structures well?
KUB

kidney
ureter
bladder
8. Aorta
5. Top of adrenal gland
7. Inferior vena cava
9. Portal vein
11. Intestine
1. Liver
12 descending colon
3. Pancreas
4. Gall bladder
5. adrenal
which is left kidney?
17
psoas shadow
what is 20?
L renal vein
most common abdominal mass in a kid
hydronepherosis
what is the diagnosis?
"Bear paw"

hydronephrosis
2 most common renal cancers?
Transitional cell carcinoma
Squamous cell
where are the most renal calculi found?

due to?
medullary

hyper Ca
if you suspect kidney or ureteral calculus what do you order 1st? 2nd?
Abdominal x-ray
Renal CT
what is a staghorn calculus?
calculus that “grows” to fill the collecting system
what is the most common mass you will see in a kidney?

**
SIMPLE renal cyst
simple cyst is best seen with what?
ultrasound
path?
polycystic kidney disease
simple cyst is best seen with what?
ultrasound
path
Polycystic Kidney Disease
round: cyst

crappy: cancer
what is this based on the number
fat
About one-third of patients have ____ at the time of diagnosis of renal cancer.
metastasis
叉子
chāzi

Gabel
Subcapsular Hematoma, complication of biopsy
diagnosis?
Angiomyolypoma
Cyst/renal cancer/or fatty tumor?
Cysts 0-20

and rounded

so CYST
renal abcess
renal laceration
another name for renal fascia is?
Gerota's fascia
kidneys are fused at their lower poles =
horseshoe kidney
Horseshoe kidney
extra kidney
most common cause of calcification of urinary wall?

****TEST
bladder schistosomiasis (parasitic disease)
bladder schistosomiasis
adrenal gland best imaged by what?
CT
CT numbers below zero help confirm what?
adenoma
adrenal is a Common organ for lung cancer ____
metastasis
adrenal adenoma
History =Trauma
Fractured kidney
gross hematuria is seen in what?
renal laceration
24% of patients with renal pedicle injury have no ___
hematuria
Cresentic lesion below the capsule, due to biopsy (subcapular hematoma)
History: automobile accident
Avulsion of the right renal artery with perfusion deficit
With major injury, one kidney lights up bright, the other is darker….
just know that
WHAT TO KNOW FOR TEST:

1. person shows up with urinary tract complaint, looking for stone.. what do you do first?

2. Abscess vs. Cyst

3. What study do you do if someone is allergic to contrast

4. In renal masses, what is most common?

5. Mass you can measure fatty measurements in, don't need to biopsy

6. kidney stones are most commonly visible under plain film xray as very dense structures but....

7. most stones of what size will pass no prob?

8. what is similar in nature to the AML but found in the adrenal gland?
1. plain film abdominal xray

2. Cyst will never have air in it, will be nice and round. Abscess has air, is bigger, gas filled

3. Ultrasound

4. Cyst

5. -40ish on CT (so you know this is an AML and is begin by nature, thus you can disregard)

6. 5-10% can't be seen with uric or cysteine acid (Cysteine and uric acid stones are radiolucent )

7. 6mm

8. AML and myolypoa are close to the same kind of lesion (multiple cell types, fat & muscle)