1
Q
kidneys development the – – – – – and ascent up to the – – – – –
A
iliac fossa , lumbar region
2
Q
which side of kidney is preferred for donation and why
A
Left kidney because left renal v is longer
3
Q
Nutcracker syndrome
A
left renal vein is compressed between SMA and aorta
4
Q
what is renal collar
A
left renal vein split in case the Aorta
5
Q
rule applicable in duplication of ureteric system
A
Weigert Meyer rule
6
Q
Weigert Meyer rule
A
ureter draining the upper pole(ectopic ureter) will open more medially and distally
in males - at the urethra
in females - at the vagina
7
Q
classical presentation in duplication of ureter
A
Mother complaints that the girl child has never been dry but also passes urine normally
8
Q
IOC duplication of ureter
A
IVU
9
Q
Mx of ectopic ureter
A
reimplantation
10
Q
drooping lily sign is seen in
A
duplication w malrotated pelvid
11
Q
Infantile PCKD is because of which gene on which chromosome
A
PKHD on chromosome 6
12
Q
adult PCKD is AD or AR
A
AD
13
Q
Adult PCKD is due to which gene on which chromosomes
A
PKD1 on chromosome 6
PKD2 on chr 4
14
Q
most common presentation of adult PCKD
A
Hypertension in a young patient
15
Q
DDX of hypertension in a young patient
A
PCKD
Renal artery stenosis
Pheochromocytoma
Hyperthyroid
16
Q
most common extra renal manifestation of PCKD
A
cysts in the liver
17
Q
extra renal manifestations in PCKD
A
- cyst in liver , spleen pancreas and lungs
- Colonic diverticulosis
- MVP
- Berry aneurysm in circle of Willis
18
Q
Mx PCKD
A
- drug’s - Vasopressin R antagonist , mTOR inhibitors
- long term dialysis
- transplant
19
Q
presentation of multicystic dysplastic kidney
A
Abdominal lump at birth
20
Q
ascent of horse shoe kidney is restricted by
A
IMA
21
Q
fuse portion of horseshoe kidney lies at level of
A
L3-L4
22
Q
In horseshoe kidney where do adrenal lie
A
normally placed
23
Q
ioc horseshoe kidney and finding
A
IVU
flower vase or handshake sign
24
Q
Mx if there is hydronephrosis or malrotated pelvis in horseshoe kidney
A
pyeloplasty
25
only indication to cut the fuse portion in a horseshoe kidney
Associated with symptomatic AAA
26
MC cause of acquired hydronephrosis
Renal stones
27
most common congenital cause of m hydronephrosis
PUJ obstruction
28
IOC for PUJ obstruction
MAG3 scan
29
MX of symptomatic PUJ obstruction
Anderson Hynes pyeloplasty
30
intra luminal causes of hydronephrosis
renal stone
Sloughed papilla
31
Intramural causes of hydronephrosis
1.PUJ obstruction
2.TCC
3. ureterocele
32
TCC finding in IVU
Goblet sign
33
I IVU finding in ureterocele
cobra head sign/ adder head sign
34
Mx ureterocele
Endoscopic procedure or excision and re-implantation
35
extra luminal causes of hydronephrosis
abberant renal vessel
advanced cancers
Retroperitoneal fibrosis
retrocaval ureter
36
retroperitoneal fibrosis is also known as
Ormonds disease
37
drug’s causing ormond disease
Methysergide
Bromocriptine
38
first structure to be involved in retroperitoneal fibrosis
ureter
39
IVU finding in ureter in retroperitoneal fibrosis
Maiden waist deformity
40
Mx of ureter in retroperitoneal fibrosis
DJ stent
41
IVU finding in retrocaval utter
fish hook / reverse J sign on R side
42
Mx retrocaval ureter
lateralisation
43
causes of b/l hydronephrosis
1. BPH
2. Bladder outlet obstruction
3. PUV
4. Phimosis
5. Meatal stenosis
44
renal isotopes scan which tells about the structure or scarring
DMSA
45
renal isotopes scan which tells about the function
DTPA
MAG3
46
indication for nephrectomy in relation with differential GFR
If hydro nephrotic kidney contributes to < 10% of total GFR
47
Most important stone inhibiting factor in kidney
Citrate
48
most common renal stones
Calcium oxalate
49
shape of calcium oxalate mono and dihydrate stones
Mono - dumbbell
Di - envelope
50
Which stones present early and why
calcium oxalate because they have spiculated margins causing early pain and Hematuria
51
Struvite stone composition
calcium magnesium ammonium phosphate (triple phosphate or staghorn stone )
52
most common organism precipitating triple phosphate stones
Proteus
53
shape of triple phosphate stone crystal
Coffin lid
54
recurrent cystine stones are managed by
D penicillinamine
55
shape of cystine stones
Hexagonal crystalline
56
most common radiolucent stones
Uric acid
57
shape of uric acid stones
Glass shards
58
Uric acid stones are seen in
Tumour lysis syndrome
Gout
59
MC presentation of renal stones
pain
60
Fixed renal pain felt at the renal angle is due to
Distension of the renal capsule
61
type of pain when stone is in Renal pelvis or upper ureter
Loin to groin type
62
•upper or mid- ureter pain in renal stone impaction
Pain can radiate along the ilio- hypogastric nerve.
63
low ureter pain in renal stone impaction
along the ilioinguinal
nerve.
64
impacted renal stone in intramural portion causes what kind of pain
strangury
65
describe strangury
intense painful urge to pass urine and intense pain at tip of penis but on trying to can only pass one or two drops of bloody urine.
66
renal stone impacted in upper ureter can present as what kind pain
pain along the obturator nerve radiating to inner aspect of thigh
67
Dietls crisis
Pain and palpable mass followed by passage of large quantities of diluted urine
68
IOC for renal stones
NCCT KUB
69
First line management of renal stones > 5MM or symptomatic
medical expulsive therapy - Tamsulosin
70
first line intervention if medical therapy fails in renal Stones
ESWL
71
complications of ES WL
Pain
Hematuria
Stone Street
UTI
72
management options if ES WL is contraindicated
URS/ RIRS
PCNL
73
c/ i of ESWL
1.pregnancy
2.Children
3.Obese
4.Bleeding disorder
5.Stone >1.5 cm
6.Cardiac pacemaker
7.Very hard stones
8.lower pole stone
9.obstructed system
74
only modality that can be used to treat renal stones more than 2 cm in size
PCNL
75
procedure done for Staghorn calculus
PCNL
76
Procedure favourable for hydro nephrotic kidney stones
PCNL
77
most common complication of PCNL
Bruising
78
IOC ureteric stones
NCCT
79
DDX ureteric stones on x-ray
1. FB
2. GB stone
3. Pills
4. Calcified 12th rib
80
first line management of ureteric stones > 5 mm
ureteroScopic removal
81
Most common stones in bladder
mixed urate
82
Jack stones
bladder stones which are spiculated calcium oxalate stones
83
First line management in bladder stones
perurethral cystolithotomy
84
Management of bladder stones where is perurethral cystolithotomy contraindicated
suprapubic cystolithotomy
85
ioc VUR
MCU
86
mx grade 1-3 VUR
antibiotic ppx
87
mx grade 4-5 VUR
ab ppx + intervention
88
open sx method for correction of VUR
re implant of ureter - Lead better pollitano technique
89
endoscopic method to treat VUR
STING,
HIT
90
ioc suspected renal injury
stable : CECT
unstable : single shot IVU
91
zone w max mortality in retroperitoneal trauma
zone 1
92
most commonly injured zone in retroperitoneal trauma
3
93
Grade 4 of renal trauma is
either vascular injury or urinary extravasation
94
DDX of non-visualised kidney on IVU
absent kidney
injury to vessels
95
MX sterile urinoma
DJ stenting
96
MX infected urinoma
Pigtail catheter drainage
97
Meteorism
colonic distention due to pressure over splanxhnic nerve after 48 to 72 hours of retroperitoneal haematoma
98
Mx ureter injury complete transection without loss of segment
anastomoses over DJ stent
99
Mx ureter injury complete transection with loss of segment
Boari flap
Psoas hitch
100
points of ureteric injury
1. while clamping the gonadal vessels
2. When clamping the uterine vessels
3. While clamping the Cardinal ligaments
101
Earliest lesion in renal TB
Papillary ulcer
102
what is putty kidney
characteristic renal calcification in genitourinary TB
103
KinKing of UPJ is called us
Kerrs kink
104
always open orifice in renal TB is called as
golf hole ureteric orifice
105
named involvements in renal TB
ghost/moth eaten calyx
putty kidney
kerr kink
golf hole ureteric orifice
thimble bladder
106
ioc renal TB
CT urography
107
classical urine finding in renal TB
sterile pyuria
108
sx mx perinephric abscess
→
Pigtail catheter
109
kinking of ureter -sx mx
DJ STENTING
110
golf hole ureteric orifice sx mx
re-implantation of ureter
111
- sx mx thimble bladder
augmentation cystoplasty using ileum
112
sx mx shortening of ureter
Boari flap
113
most common organism causing pyonephritis
E. coli
114
ioc pyelonephritis
CECT
115
ioc emphysematous pyelonephritis
CECT
116
MC organism implicated in xanthogranulomatous pyelonephritis
Proteus > e. coli
117
mx xanthogranulomatous pyelonephritis
sub capsular nephrectomy
118
classical presentation of xanthogranulomatous pyelonephritis
Middle aged female diabetic with flank pain and abdominal mass and calculi
119
classification of renal lesions on ultrasound/ CT is called as
Bosniak classification
120
Bosniak 3 - description work up and risk of malignancy
indeterminate
Partial nephrectomy
50%
121
angiomyolipoma arises from
peri vascular epitheloid cells
122
familial angiomyolipoma is commonly in
Tuberous sclerosis
123
Wunderlich syndrome
spontaneous retroperitoneal haemorrhage from an angiomyolipoma
124
triad in Wunderlich syndrome
Lenk triad
pain
flank mass
hypotension
No haematuria
125
Management of symptomatic angiomyolipoma
partial nephrectomy
126
management of bleeding angiomyolipoma
angioembolisation followed by partial nephrectomy
127
most common benign tumour of kidney and where does it arise from
oncocytoma
oncocytes (cells rich in mitochondria )
128
familial onco cytoma is seen in
Birt Hogg Dube syndrome
129
characteristic finding of oncocytoma on CECT
Central stellate scar
130
Central stellate scar ddx
oncoCytoma
Chromophobe RCC
FNH liver
131
RCC other names
Grawitz
hypernephroma
internists tumor
132
MC type of RCC and its associated syndrome and which cel it arises from
Clear cell
VHL syndrome
PCT
133
Papillary RCC mutation and cell it rises from
CMET
PCT > DCT
134
RCC associated with long-term dialysis therapy
Papillary RCC
135
RCC with best prognosis
Chromophobe
136
HPE chromophobe RCC
plant like cells
Resin like nucleus
137
RCC with worst prognosis and cell it arises from
Collecting duct / Bellini cancers
138
type of RCC found with sickle anaemia
medullary
139
Classical triad of RCC
mass
pain
hematuria
140
Single most common presentation of RCC
hematuria
141
MC site of m metastasis of RCC
Lung cannon ball
142
most common paraneoplastic syndrome in RCC
Raised ESR
143
stauffer syndrome
Paraneoplastic syndrome
non metastatic hepatic dysfunction
144
cytokine elevated in stauffer syndrome
IL6
145
T4 disease RCC involves
tumour invades beyond gerota fascia and/or extension into ipsilateral adrenal
146
Indications for partial nephrectomy
1. T1
2. tumour restricted to poles
3. bilateral tumour
4. RCC in solitary functioning kidney
147
Structures removed in radical nephrectomy
kidney,
Gerota fascia
para aortic lymph nodes
ureteric removal till pelvic brim
148
most important prognostic factor in RCC
pathological stage
149
grading system for rcc
fuhrman
150
Most important diagnostic factor in Wilm tumour
histological findings
Surgery
flashcards
Decks in class (20)
# Cards
-
Esophagus125
-
Stomach118
-
Upper GI Hge37
-
Bariatric Sx16
-
Intestinal Obstruction94
-
Small and Large Bowel53
-
Appendix64
-
Colorectal polyps and Cancer84
-
Rectum and Anal Canal70
-
Liver78
-
Spleen18
-
Gall Bladder64
-
Pancreas124
-
Testicular disorders65
-
Kidney150
-
Bladder, Urethra and Penile disorders72
-
Prostate81
-
Thorax32
-
General Surgery89
-
Neurosurgery42
