index int64 0 999 | text stringlengths 4 4.25k | embedding listlengths 3.58k 4.1k |
|---|---|---|
968 | 4. Wilms tumor
B. BENIGN TUMOR
5. Angiomyolipoma
6. Nephroblastomatosis
C. CYSTS
7. Adult polycystic kidney disease
8. Acquired cystic kidney disease
# Unilateral Renal Mass
## Solid Renal Mass
A. TUMORS
(a) primary malignant:
> epithelial tumor of renal parenchyma: adenocarcinoma ( $83 \%$ ), papillary neoplasm ( ... | [
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969 | other disease
# Calcified Renal Mass
$\diamond$ A calcified renal mass is malignant in $75 \%$ of cases!
$\diamond$ Lesions with
(a) nonperipheral calcifications are malignant in $87 \%$ !
(b) peripheral calcifications are malignant in $20 \%$ !
A. MALIGNANT TUMOR
1. Renal cell carcinoma (calcifies in $8-20 \%$ )
$... | [
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970 | Edema
Abscess
Tumor
# Growth Pattern of Renal Lesions
## Renal Lesion with Expansile Growth Pattern
1. Renal cell carcinoma
2. Oncocytoma
3. Angiomyolipoma
4. Juxtaglomerular tumor
5. Metastatic tumor: eg, lymphoma
6. Mesenchymal tumor
## Renal Lesions with Infiltrative Growth Pattern
Imaging hallmarks:
$\checkma... | [
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971 | (e) metastases: esp. lung cancer
(f) renal sarcomas
(g) pediatric tumor
1. Mesoblastic nephroma
2. Rhabdoid tumor of the kidney
3. Nephroblastomatosis
4. Primitive neuroectodermal tumor
5. Wilms tumor (unusual)
B. INFLAMMATION
6. Bacterial pyelonephritis
7. Xanthogranulomatous pyelonephritis
8. Renal parenchymal malak... | [
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972 | 2. Acute focal bacterial nephritis
B. BENIGN TUMOR
3. Angiomyolipoma
4. Cavernous renal hemangioma
5. Oncocytoma
C. MALIGNANCY
6. Renal cell carcinoma
7. Angiosarcoma
8. Undifferentiated sarcoma
9. Metastasis
# Hyperattenuating Renal Mass on NECT
$=$ attenuation higher than
(a) renal parenchyma $(>40 \mathrm{HU})$
(... | [
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-0.... |
973 | 6. Oncocytoma engulfing renal sinus fat
7. Renal cell carcinoma
(a) invasion of perirenal fat
(b) intratumoral metaplasia into fatty marrow (in $32 \%$ of RCCs $<3 \mathrm{~cm}$ in diameter)
$\diamond$ If a lesion contains fat + calcium RCC is likely, NOT angiomyolipoma!
# Renal Pseudotumor
$=$ normal renal tissue m... | [
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0... |
974 | $\sqrt{ }$ "mass" enhances identically to renal parenchyma
$D D x$ : accessory spleen, medial lobule of spleen, splenosis, normal / abnormal bowel, pancreatic disease, gallbladder, adrenal abnormalities
$D x$ : static radionuclide imaging / renal arteriography / CT
# Pseudokidney Sign
= sonographic mass of reniform ... | [
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0.021484375,
-0.018676757... |
975 | 4. Infectious cysts: TB, Echinococcus, abscess
5. Medullary necrosis
6. Pyelogenic cyst
7. Lithium-induced nephropathy
D. CYSTS ASSOCIATED WITH SYSTEMIC DISEASE
8. Tuberous sclerosis
9. Von Hippel-Lindau disease
E. CYSTIC TUMORS
10. Multilocular cystic nephroma
11. Cystic Wilms tumor
12. Cystic renal cell carcinoma
13.... | [
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0.02697753906... |
976 | 3. Meckel-Gruber syndrome
4. Jeune syndrome
5. Zellweger syndrome $=$ cerebrohepatorenal syndrome
6. Conradi syndrome $=$ chondrodysplasia punctata
7. Orofacialdigital syndrome
8. Trisomy 13
9. Turner syndrome
10. Dandy-Walker malformation
# Multiloculated Renal Mass
$=>3-4$ septations
$R x:$ most multiloculated ren... | [
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0.0126342773... |
977 | # Segmental Absence of Nephrogram
A. SPACE-OCCUPYING PROCESS
1. Neoplasm
2. Cyst
3. Abscess
B. FOCAL RENAL INFARCTION
4. Arterial embolus / thrombosis
5. Vasculitis, collagen-vascular disease
6. Sickle cell anemia
7. Septic shock
8. Renal vein thrombosis
## Rim Nephrogram
$=$ rim of cortex receiving collateral blo... | [
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... |
978 | 3. Systemic hypotension
4. Autosomal recessive PCKD
5. Medullary sponge kidney
6. Medullary cystic disease
mnemonic: CHOIR BOY
Contusion
Hypotension (systemic)
Obstruction (ureteral)
Intratubular obstruction
Renal vein thrombosis
Bacterial nephritis (acute)
Obstruction (ureteral) — it is so common!
Yes, also cystic dis... | [
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0.01385498046875... |
979 | $\checkmark$ hyperconcentration in collecting system
$\checkmark$ ureteral notching
NUC (glomerular filtration agent [eg, ${ }^{99 \mathrm{~m}} \mathrm{Tc}$-DTPA] preferred):
$\checkmark$ decreased perfusion with prolonged excretory phase
C. IMPAIRED PERFUSION OF SMALL ARTERIES
Trueta shunting $=$ transient rerouting ... | [
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0.00482177734... |
980 | # A. PROXIMAL TUBULE
Function: reabsorbs almost all of glucose, amino acids, phosphate, bicarbonate
- glycosuria: Toni-Fanconi syndrome
- aminoaciduria: cystinuria
- phosphaturia: phosphate diabetes, thiazides
- HCO3- wasting: proximal renal tubular acidosis
B. DISTALTUBULE
Function: absorbs most of water
- diabet... | [
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0.038818359375,
-... |
981 | # Vicarious Contrast Material Excretion during IVP
$=$ biliary contrast material detected radiographically following intravenous administration of contrast material
Normal contrast excretion:
$<2 \%$ of urographic dose of diatrizoates + iothalamates are handled by hepatobiliary excretion
Pathophysiology: increase in ... | [
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0.01708... |
982 | (d) external trauma
(e) external compression
(f) pressure necrosis due to stone
Types:
1. Pyelotubular backflow
$=$ opacification of terminal portions of collecting ducts ( $=$ papillary ducts $=$ ducts of Bellini) as a physiologic phenomenon (in $13 \%$ with low osmolality + in $0.4 \%$ with high osmolality contrast... | [
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-0.0269775390625,
-0.040771484375,
0.01635... |
983 | 2. Pregnancy
3. Retroperitoneal fibrosis
(d) overdistended urinary bladder
(e) previous long-standing significant obstruction: dilatation remains in spite of relief of obstruction
# Caliceal Abnormalities
A. OPACIFICATION OF COLLECTING TUBULES
1. Pyelorenal backflow
2. Medullary sponge kidney
B. PAPILLARY CAVITY
3.... | [
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-0.037841796875,
-0.0140991210937... |
984 | 3. Fungus ball = conglomeration of fibrillar hyphae
4. Inspissated debris ("mucopus")
C. VASCULAR
5. Blood clot: history of hematuria
$\checkmark$ change in appearance over time
D. FOREIGN MATERIAL
6. Air from bladder via reverse peristalsis, direct trauma, renoalimentary fistula
7. Foreign matter
# Mucosal Mass in Co... | [
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-0.03857421875,
... |
985 | 3. IVC occlusion
4. Vascular malformation
5. Retroaortic left renal vein
6. "Nutcracker" effect on left renal vein between aorta and SMA
7. Polyarteritis nodosa
D. PROMINENT MUCOSAL FOLDS
8. Redundant longitudinal mucosal folds of intermittent hydronephrosis: UPJ obstruction, vesicoureteral reflux / after relief of obs... | [
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-0.01141357421875,
-0.030029296875,
-0.00933837890... |
986 | # RENAL SINUS
## Renal Sinus Mass
A. TUMOR
(a) renal pelvis
1. Transitional cell carcinoma $(90 \%)$
2. Squamous cell carcinoma $(9 \%)$
3. Mucinous adenocarcinoma $(1 \%)$
(b) renal parenchyma
4. Renal cell carcinoma
5. Multilocular cystic nephroma
6. Plasmacytoma
(c) mesenchymal tumor (rare): hemangioma, lipoma, ... | [
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987 | # Retroperitoneal Calcification
A. NEOPLASM
1. Wilms tumor (in $10 \%$ )
2. Neuroblastoma (in 50\%): fine granular / stippled / amorphous
3. Teratoma: cartilage / bone / teeth, pseudodigits, pseudolimbs
4. Cavernous hemangioma: phleboliths
B. INFECTION
5. Tuberculous psoas abscess
6. Hydatid cyst
7. Alkaline-encrust... | [
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... |
988 | 2. Milk-alkali syndrome $=$ excess calcium + alkali $\leftarrow$ milk + antacids
3. Hypervitaminosis D
4. Beryllium poisoning
(c) osseous
5. Osseous metastases, multiple myeloma
6. Prolonged immobilization
7. Progressive senile osteoporosis
(d) renal
8. Medullary sponge kidney
9. Distal renal tubular acidosis (in $73 \... | [
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989 | Hypercalcemia / hypercalciuria (sarcoidosis, milk-alkali syndrome, hypervitaminosis D)
Oxalosis
Papillary necrosis
$\sqrt{ }$ normal-sized / occasionally enlarged kidneys (medullary sponge kidney)
$\sqrt{ }$ small poorly defined / large coarse granular calcifications in renal pyramids:
$\checkmark$ uniform deposition:... | [
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990 | - Normocalcemia + Normocalciuria
1. Acetazolamide
2. Hyperoxaluria
# Cortical Nephrocalcinosis (5\%)
= calcium deposition in renal cortex
Frequency: $5 \%$ of all nephrocalcinoses
Cause:
1. Acute cortical necrosis
2. Chronic glomerulonephritis
3. Alport syndrome
4. Congenital oxalosis, primary hyperoxaluria
5. Chr... | [
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991 | 1. Angiomyolipoma (16-24\%)
2. Lipoma
3. Adenoma
4. Fibromyoma
5. Ruptured hemorrhagic cyst
B. VASCULAR DISEASE (18-26\%)
6. Ruptured renal artery aneurysm
7. Vasculitis: eg, polyarteritis nodosa in $13 \%$
8. Arteriovenous malformation
9. Segmental renal infarction
C. INFLAMMATION / INFECTION (7-10\%)
10. Abscess (in ... | [
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0.0009231567382810001,
-0.0301513671875,
-0.038818359375,
-0.007... |
992 | # B. SMOOTH MUSCLE DYSFUNCTION
1. UPJ obstruction
2. Primary megaureter
C. ABNORMAL TERMINATION OF SINGLE URETER
3. Ectopic ureter
4. Ureterocele
5. Vesicoureteral reflux
## Ureteral Deviation in Course
A. LUMBAR URETER
(a) lateral deviation (common)
1. Hypertrophy of psoas muscle
2. Enlargement of paracaval / par... | [
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993 | 4. Prune-belly syndrome
5. Ectopic ureter
6. Ureterocele
C. INFECTION / INFLAMMATION impairing ureteral peristalsis
7. UTI: eg, E. coli, Pseudomonas, Citrobacter
8. Appendicitis
9. Diverticulitis
D. COMPRESSION
10. Pelvic / abdominal mass
11. Vessel:
> retroiliac / retrocaval course of ureter
> ovarian vein syndrome
#... | [
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0.00364685058... |
994 | C. nonreflux-nonobstructed MEGAURETER
1. Congenital primary megaureter $=$ megaloureter
2. Polyuria: eg, diabetes insipidus, acute diuresis
3. Infection
4. Ureter remaining wide after relief of obstruction
mnemonic: DiaPOUR
Diabetes insipidus
Primary megaureter
Obstruction (recent / old)
UVJ obstruction
Reflux
# Uret... | [
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0.01708984375,
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0.00277709... |
995 | Endometriosis + other periureteral inflammatory process
Radiation therapy, Retroperitoneal fibrosis
Physiologic narrowing is common and characterized by absence of proximal dilatation and rapid changeability.
$D D x$ : Physiologic narrowing
1. Ongoing peristalsis $\rightarrow$ incomplete opacification resolved on dela... | [
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0.0296630859375,
-0.0230712890625,
-0.023681640625,
0.007049560546875001,
0.0286865234375,
-0.032958984375,
0.017578125,
-0.0123291015625,
-0.0208740234375,
-0.0245361328125,
-0.042236... |
996 | 3. Amyloid infiltration
4. Ureteral tumor
DDx: (1) Phlebolith in gonadal vein (multiple, not along course of ureter, centrally radiolucent)
(2) Orally administered contrast material trapped in appendix / diverticulum
(3) Dermoid cyst with calcification
(4) Silastic fallopian tube band
(5) Radiation seeds used for pros... | [
0.024169921875,
0.0038757324218750004,
0.033935546875,
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0.01708984375,
0.02783203125,
-0.009033203125,
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0.02294921875,
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-0.0087890625,
-0.01806640625,
-0.00012111663818300001,
-0.028808593749999997,
-0.01745605468... |
997 | Lipomatosis, pelvic
Lymphadenopathy (pelvic)
# Small Bladder Capacity
## Cause:
A. THICKENED / FIBROTIC BLADDER WALL
1. Interstitial cystitis
2. Tuberculous cystitis
3. Cystitis cystica
4. Schistosomiasis
5. Trauma: surgical resection, radiation therapy
B. DISUSE OF BLADDER
- urinary frequency
- progressive rise ... | [
0.004486083984375,
-0.0166015625,
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0.01287841796875,
0.021240234375,
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-0.0286865234375,
-0.02600... |
998 | 4. Malakoplakia
5. Extravesical inflammation:
(a) Diverticulitis
(b) Crohn disease
(c) endometriosis
D. HEMATOMA
after instrumentation, surgery, trauma
# Bladder Tumor
Frequency: $2-6 \%$ of all tumors
A. EPITHELIAL TUMORS ( $95 \%$ )
1. Urothelial carcinoma $=$ transitional cell carcinoma $(90 \%)$
2. Squamous cel... | [
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0.009033203125,
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... |
999 | $\sqrt{ }$ hypointense mass on T1WI
$\sqrt{ }$ "target" sign on T2WI in plexiform neurofibroma= central hypointense fibrosis surrounded by hyperintense myxoid stroma
2. Paraganglioma $=$ pheochromocytoma $(0.1 \%)$
$\diamond 1 \%$ of all pheochromocytomas
Age: $10-78$ years; $\mathrm{M}<\mathrm{F}$
Origin: paraganglia ... | [
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0.01239013671875,
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-0.03515625,
0.0... |
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