| Question | Answer |
| What radiologic studies need contrast? | CT scan
Intravenous Pyelogram
MR Angiogram |
| Which studies have radiation? | X-ray
IVP
CT |
| Which studies don't have radiation? | Ultrasound
MRI |
| What is the most common renal mass and how do you find them? | Simple renal cysts (90% of all masses)
Seen on ultrasound as anechoic areas (smooth, round, black hole) |
| What is the most common renal cancer? | Renal adenocarcinoma |
| What does trauma to the kidney look like? | Blood extending out in to Gerota's fascia
There may be damage to the pancrease |
| Name, in order, the studies you order to look for kidney abnormalities. | Plain film X-ray
IVP (not so much)
CT scan (if looking for stones, don't use contrast)
Ultrasound
MRI |
| What are the contraindication for contrast use in IVP? | Hx of hypersensitivity
Combined renal and hepatic dz
Oliguria
Diabetes with renal insufficiency
Glucophage |
| How long does an IVP take? | 20 minutes |
| What does the kidney look like on ultrasound? | A football (long axis view) |
| What muscle do the kidneys travel next to? | The psoas |
| Name urine draining kidney anatomy going from proximal to distal. | (CIPU)
Calyx
Infundibulum
Pelvis
Ureter |
| What does a full column seen in IVP indicate? | Possible obstruction |
| True/False
Larger stones cause more pain. | False
They cause less. |
| What organisms are staghorn calculi associated with? | Proteus
Klebsiella |
| If you suspect a calculi, list the imaging studies in order. | Abdominal X-ray
Renal CT
IVP
Renal Ultrasound |
| What does a renal cyst look like on CT? | No visible wall
Sharply marginated
Low density (0-10 H.U.) |
| What is the density of fat on CT? | -10 to -40 |
| Where does renal cancer metastasize most often? | Lung, but also to the bone and brain. |
| What percentage of pts have metastasis at time of Dx? | About 1/3 |
| What is a bear paw sign? | Seen on IVP as a sign of hydronephrosis |
| What is the range for normal kidney size? | Between 9am and 13cm |
| In a horseshoe kidney, where are they connected? | They are fused at the lower poles |
| What is the best way to visualize the adrenal glands? | Best imaged with CT |
| What does adrenal adenoma look like on CT? | Round, mass with Ct numbers <0 |
| Name some causes of Renal lacerations. | MVA
Falls and fights
Contact sports |
| What is the mechanism of renal lacerations? | Direct blow compress the thorax and causes laceration by lower ribs
Accel/decel injuries can produce renal artery tears |
| What are some signs and symptoms with RL? | >95% hematuria
24% don't have hematuria
1-2% only have microhematuria |
