genitourinary viva presentation for exam.pdf

genitourinary

2. S/No Case S/No Case
1 Pheochromocytoma 21 Urethral Trauma
2 Adrenal Myelolipoma 22 CA Prostate
3 Adrenal Adenoma 23 Cystitis
4 Adrenal Malignancy (CA, Mets & Lymphoma) 24 Urethral Stricture
5 RCC 25 GU TB
6 UB Rupture 26 Urachal Pathologies
7 Renal AML (Tuberous Sclerosis) 27 Epididymitis
8 Nephrocalcinosis 28 Renal Lymphoma & Mets
9 Adult Polycystic Kidney Disease 29 Medullary Sponge Kidney
10 Renal Papillary Necrosis 30 Multicystic Dysplastic Kidneys
11 Pyelonephritis & Renal Abscess 31 PAN
12 Nephrolithiasis 32 Testicular Tumors
13 Duplication Anomalies 33 Page Kidney
14 Renal Cysts 34 Testicular Microlithiasis
15 Renal Oncocytoma 35 Urethral Diverticulum
16 TCC 36 Renal Ectopia
17 TCC (UB) 37 Retrocaval Ureter / PUJ Obstruction
18 Horseshoe Kidney 38 Testicular Epidermoid
19 Ureteritis Cystica 39 UB / Hutch Diverticulum
20 Shock / Hypoperfusion Complex 40 Ureteral Pseudodiverticulosis

3. S/No Case S/No Case
41 XGP 61 UB Fistula
42 Calyceal Diverticulum 62 Neurogenic Bladder
43 Fournier Gangrene 63 Cryptorchidism
44 Retroperitoneal Fibrosis 64 Prostatitis
45 Testicular Torsion 65 Hydrocele
46 Seminal Vesicle Cyst 66 Varicocele
47 Tubular Ectasia of Rete Testes 67 BPH
48 Schistosomiasis 68 Scrotal Trauma
49 Adrenal Hemorrhage 69
50 Retroperitoneal Hemorrhage 70
51 Retroperitoneal Malignancies 71
52 Adrenal Calcification (TB / Fungal Infections) 72
53 Adrenal Cyst 73
54 VHL 74
55 RAS & Renal Infarction 75
56 RVT 76
57 Renal Trauma 77
58 Multilocular Cystic Nephroma 78
59 Ureterocele 79
60 Ectopic Ureter 80

22. Pheochromocytoma
CT Scan (Axial) View
Cystic area with air fluid level in the Lt thorax
Next
MIBG (Meta-Iodo-Benzyl-Guanidine) Scan

32. Adrenal Myelolipoma
CT Scan (Axial) View
Heterogenous, predominantly fatty, Rt adrenal mass with calcified focus
Next
MIBG (Meta-Iodo-Benzyl-Guanidine) Scan

41. Adrenal Adenoma
In Phase/Out of Phase MRI (Axial) View
Fat containing lesion seen in the adrenal
Next
MIBG (Meta-Iodo-Benzyl-Guanidine) Scan

50. Adrenal Malignancy
CT Scan (Axial) View
Bilateral adrenal masses with heterogenous texture
Next
Biopsy

62. RCC
CT Scan (Axial) View
Large soft tissue density lobulated Lt renal mass
Less enhancing as compared to the renal parenchyma
Next
Biopsy

63. 74- ROBSON CLASSIFICATION OF RCC
Stage-I Tumor limited to kidney/renal capsule
Stage-II Extra-renal/adrenal involvement but limited to Gerota
fascia
Stage-III A-Involvement of renal vein/IVC
B-Involvement of regional lymph nodes
C-Both A & B
Stage-IV A-Adjacent visceral involvement
B-Mets
Lungs (55%)
Liver (25%)
Bones (20%)
Adrenal (20%)
Contralateral kidney (10%)
Others (< 5%)

74. UB Rupture
Cystogram (Frontal) View
Multiple pelvis fracture & extraperitoneal rupture
Next
Rx & Follow Up

86. Renal AML (Tuberous Sclerosis)
CT Scan (Axial) View
Multiple bilateral renal masses containing fat within
CT Scan brain (Axial) View
Multiple calcified tubers in peri ventricular region
Next
Biopsy

99. Nephrocalcinosis
USG Abdomen
Calcification of renal medulla
Next
Biopsy

108. Adult Polycystic Kidney Disease
CT Scan (Axial) View
Multiple bilateral renal cysts with associated cysts in the liver & pancreas
Next
Follow Up

116. Renal Papillary Necrosis
IVU
De-shaped, cup shaped renal papillae seen bilaterally
Next
Follow Up

123. Pyelonephritis & Complications
CT Scan (Axial) View
Bilateral swollen kidneys with striated nephrogram
Next
Rx & Follow Up

139. Nephrolithiasis
CT Scan (Axial) View
Hyperdense calculus at Rt VUJ
Next
Rx & Follow Up

147. Duplication Anomalies
IVU
Dilated lower moiety of duplex renal system on Rt side
Next
Rx & Follow Up

155. Renal Cysts
CT Scan (Axial) View
Hypodense Rt renal mass
Next
Follow Up

164. Renal Oncocytoma
T2WI (Axial) View
T2WI hyperintense mass with spoke wheel appearance seen in Rt kidney
Next
Biopsy

172. TCC
IVU
Oncocalices in upper pole, distended with tumor
Next
Biopsy

181. TCC (UB)
IVU
Soft tissue density mass with the UB, causing distortion of the mucosa
Next
Cystoscopy & Biopsy

182. STAGING OF CA BLADDER
Stage-I Mucosal/submucosal lesions
Stage-II Superficial muscular lesions
Stage-III A- Deep muscular involvement
B- Peri-vesicle fat involvement
Stage-IV Other organs involvement

190. Horseshoe Kidney
IVU
Dilated pelvicalyceal system with medial deviation of inferior poles, connected
between the kidney
Next
CT Scan

200. Ureteritis Cystica
IVU
Multiple, small filling defects in Rt ureter
Clubbing of lower calyces also seen on Rt side
Next
CT Scan

207. Shock Complex
CECT Scan (Axial) View
Intense enhancement of bowel wall, kidneys, aorta & IVC
The IVC also seen collapsed
Next
Rx & Follow Up

214. Urethral Injury (Type-III)
Cystourethrogram
Extravasation of the contrast material into the perineum from prostatic urethra
There is also tear of bulbar urethra
Next
Rx & Follow Up

221. CA Prostate
TRUS
Enlarged prostate with hypoechoic lesion within the prostate
Next
MRI
STAGING OF CA PROSTATE
Stage-I  Non-palpable tumor
 Found on biopsy
 Radical prostactomy
Stage-II  Palpable tumor
 Confined to prostate
 One lobe (a) & both lobes (b)
 Radical prostactomy
Stage-III  Extension through prostatic capsule
 No mets
 Radiation therapy
Stage-IV  Mets
 Hormonal therapy, radio & chemo therapy

231. Cystitis
USG Pelvis
UB wall is thickened
No calcification is seen
Next
MRI

240. Urethral Strictures
Urethrogram
Smooth, short stricture seen in the posterior urethra
Next
MRI

248. Renal TB
IVU
Putty (Calcified) kidney on Lt side, showing amorphous calcification
Next
CT Scan

257. Urachal CA
CT Scan (Axial) View
Soft tissue density mass with calcification seen in the pelvis, superior to the UB
Next
Biopsy

258. 85- STAGING OF URACHAL CA
I  Cancer limited to urachus
I
I
 Invasion limited to
urachus
I
I
I
A  Local invasion of the UB
B  Invasion of the abdominal
wall
C  Invasion of the
peritoneum
D  Invasion of other viscera
I
V
A  Mets to local lymph
nodes
B  Mets to other viscera

266. Epididymitis
USG Testes
Swelling and decreased echogenicity of the epididymis
Next
Rx & Follow Up

277. Renal Lymphoma
CT Scan (Axial) View
Multiple hypodense , non enhancing lesions seen within the both kidneys
Next
Biopsy

287. Medullary Sponge Kidney
IVU
Bilateral medullary nephrocalcinosis
Next
CT Scan

299. Multicystic Dysplastic Kidney
USG
Multiple thin walled renal cysts of variable sizes
Next
IVU / Nuclear Scan

309. Polyarteritis Nodosa
Angiogram
Microaneurysms seen in renal vasculature
Next
Evaluate visceral arteries

313. Testicular Tumors
USG
Uniform hypoechoic solid mass (arrow) in testes
Next
Biopsy

315. STAGING OF TESTICULAR TUMORS
I Limited to testes & spermatic cord
II Mets to lymph nodes below the
diaphragm
A < 2 cm ( < 6 lymph nodes)
B > 2 cm ( > 6 lymph nodes)
C Bulky mass (5-10 cm)
III Mets to lymph nodes above the
diaphragm
A Confined to lymphatic system
B Extra-nodal mets

325. Subcapsular Hematoma (Page Kidney)
CT Scan (Axial) View
Non-enhancing soft tissue lesion in subcapsular area of LT kidney with associated
ipsilateral atrophy
Next
Rx & Follow Up

331. Testicular Microlithiasis
USG Testes
Multiple, small calcified areas scattered throughout the testes
Next
Follow Up

335. Urethral Diverticulum
Cystourethrogram
Contrast filled outpouching seen in the posterior urethra
Next
Rx & Follow Up

341. Crossed Fused Ectopia
CT Scan (Axial) View
Embryonic left in an inferior crossed ectopic location
Note dilated Lt renal artery (arrow) & renal pelvis opening towards the Rt
Next
Follow Up

349. Retrocaval Ureter
CT Scan (Axial) View
Dilatation of the upper part of Rt ureter is seen, because of its course behind the IVC
Next
Follow Up

359. Testicular Epidermoid
USG
Well circumscribed, hypoechoic lesion with echogenic capsule (onion skin appearance)
Have internal shadows (may be due to calcifications)
Next
Biopsy
STAGING OF TESTICULAR TUMORS
I Limited to testes & spermatic cord
II Mets to lymph nodes below the
diaphragm
A < 2 cm ( < 6 lymph nodes)
B > 2 cm ( > 6 lymph nodes)
C Bulky mass (5-10 cm)
III Mets to lymph nodes above the
diaphragm
A Confined to lymphatic system
B Extra-nodal mets

366. Hutch Diverticulum
Cystography
Contrast filled, smooth walled outpouching of the UB at VUJ
Next
Rx & Follow Up

377. Ureteral Pseudodiverticulosis
Cystography
Small, contrast filled outpouching in the ureteral lumen
Next
Rx & Follow Up

383. XGP
CT Scan (Axial) View
Bilateral renal calculi
Enlarged lobulated Rt kidney with hypoechoic areas
Next
Rx & Follow Up

395. Calyceal Diverticulum
IVU
Contrast filled outpouching seen in the Rt calyceal system
Next
Rx & Follow Up

402. Fournier's Gangrene
CT Scan (Axial) View
Scrotal skin thickening with subcutaneous emphysema noted
Next
Rx & Follow Up

408. Retroperitoneal Fibrosis
IVU
Medial deviation of ureter is seen without any other finding
Next
CT Scan (Axial) View

420. Testicular Torsion
USG (Doppler) Testes
No blood flow seen on Rt side
Normal blood flow on Lt side
Next
Rx & Follow Up

434. Seminal Vesicle Cyst
CT Scan (Axial) View
Fluid density lesion seen in the pelvis, inferior to the UB
Next
Aspiration & Cytology

440. Tubular Ectasia Of Rete Testes
USG Testes
Small hypoechoic areas with echogenic walls are seen in the testes
Next
Follow Up

444. Seminal Vesicle Cyst
CT Scan (Axial) View
Calcification of the UB wall is seen
Next
CT Scan

450. Adrenal Hemorrhage
CT Scan (Axial) View
Fluid density areas with well-defined margins is seen in the Rt suprarenal area
Next
Rx & Follow Up

458. Retroperitoneal Hemorrhage
CT Scan (Axial) View
Spontaneous hemorrhage into multiple sites in the retroperitoneum & body wall in an
anticoagulated pt
Next
Rx & Follow Up

466. Retroperitoneal Sarcoma
CT Scan (Axial) View
Liposarcoma with heterogenous areas whose attenuation is similar to fat or soft tissue (arrow)
Next
Biopsy

481. Adrenal Calcification
CT Scan (Axial) View
Nodular calcification & atrophy of adrenal glands is seen
Next
Rx & Follow Up

487. Adrenal Cyst
USG Abdomen
Sagittal view shows lucent mass above the Rt kidney
Next
CT Scan

494. VHL
CT Scan (Axial) View
Multiple pancreatic & renal cysts & RCC (arrow) in VHL
Next
Rx & Follow Up

501. RAS
Angiography
Small Lt renal artery (& kidney)
Rt renal artery is concentrically stenotic just beyond its origin from atherosclerosis
Next
Rx & Follow Up

512. RVT
CT Scan (Axial) View
Renal vein thrombosis extending into the IVC
Next
Venogram

520. Renal Trauma
CT Scan (Axial) View
Deep laceration of Rt kidney with perirenal blood & active hemorrhage (arrow)
Next
Rx & Follow Up

522. 83- CLASSIFICATION OF RENAL TRAUMA (974-S)
FEDERAL IMAGING CLASSIFICATION AAST CLASSIFICATION
I Minor contusion
Cortical contusion not extending into the
calyces
1 Contusion
± Subcapsular hematomas
2 Cortical laceration < 1cm not
extending into calyces
3 Cortical laceration > 1cm not
extending into calyces
II Major cortical laceration extending into
collecting system (Renal fracture)
4 Cortical laceration extending
into corticomedullary junction
III Catastrophic renal pedicle
IV Pelvi-ureteric /renal pedicle injury
Shattered kidney
5 Renal artery/vein injury with
contained hemorrhage
Renal pedicle injury
Shattered kidney

532. Multilocular Cystic Nephroma
CT Scan (Axial) View
Multilocular cystic mass with enhancing septa
Next
Aspiration & Cytology

540. Ureterocele
CT Scan (Axial) View
Large left orthotopic ureterocele (arrow)
IVU
Complete left system duplication & ectopic ureterocele at UB base (arrow)
Filling defect in dilated ureter (open arrow) represents ureteritis cystica
Next
Rx & Follow Up

550. Ectopic Ureter
IVU
Opacification of dilated, tortuous ectopic ureter & severely hydronephrotic upper pole moiety
Note displaced lower pole moiety
Next
Rx & Follow Up

556. UB Fistula
Cystogram
Filling of vagina posteriorly (arrows) in pt with vesicovaginal fistula following hysterectomy
Next
Rx & Follow Up

563. Neurogenic Bladder
Cystogram
Pine cone bladder, elongated & pointed with pseudodiverticula (arrow)
Next
Rx & Follow Up

573. Cryptorchidism
CT Scan (Axial) View
Ovoid mass (arrow) anterior to left iliac vessels replacing undescended testes
Next
Biopsy

580. Prostatitis
CT Scan (Axial) View
Low attenuation lesion with rim enhancement in the central portion of right prostate lobe,
consistent with abscess
Next
Rx & Follow Up

586. Hydrocele
USG Testes
Anechoic collection anterior & lateral to normal testis (arrow)
Next
Aspiration & Cytology

592. Varicocele
Doppler USG Testes
Multiple color-coded venous channels within epididymis (arrow)
Next
Aspiration & Cytology

593. GRADING OF VARICOCELE
Grade Relaxed state During Valsalva
Normal < 2.5 mm 2.7 mm
Small 2.5-4.0 mm ↑ by 1.0 mm
Moderate 4.0-5.0 mm ↑ by 1.2-1.5 mm
Large > 5.0 mm ↑ by > 1.5 mm

598. BPH
IVU
Extrinsic impression (open arrow) on the base of UB with fish hooking of the left ureter (arrow)
Next
Follow Up

604. Scrotal Trauma
USG
Hypoechoic fracture traversing the testis (arrow)
Next
Follow Up