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Paper 3
Published in Amanda Rabone, Benedict Thomson, Nicky Dineen, Vincent Helyar, Aidan Shaw, The Final FRCR, 2020
Amanda Rabone, Benedict Thomson, Nicky Dineen, Vincent Helyar, Aidan Shaw
A 16 year old female patient has a urinary tract ultrasound following several urinary tract infections. This shows the right kidney is atrophic and the left kidney is normal in appearance. Previous ultrasound from when the patient was younger demonstrated a large right kidney. There is no hydronephrosis and the renal hilum is normal; however, there are multiple anechoic right renal lesions varying in size. These are separated by hyperechoic linear tissue without increased vascularity.
Bladder Cancer
Published in Pat Price, Karol Sikora, Treatment of Cancer, 2020
Urological opinion should be sought in any case of macroscopic hematuria or persistent microscopic hematuria. Presence of a proven urinary tract infection does not remove the need to investigate hematuria as the detection rate of urological malignancy is similar to that in those without UTI in patients presenting to a hematuria clinic.8 Current recommendations include CT urogram or urinary tract ultrasound, urine for culture and sensitivity, and cystoscopy. When cystoscopy detects a bladder tumor, ipsilateral hydronephrosis on concurrent imaging is associated with muscle-invasive bladder carcinoma (approximately 90% of cases) and its presence should prompt rigorous investigation.
Test Paper 6
Published in Teck Yew Chin, Susan Cheng Shelmerdine, Akash Ganguly, Chinedum Anosike, Get Through, 2017
Teck Yew Chin, Susan Cheng Shelmerdine, Akash Ganguly, Chinedum Anosike
A 5-month-old infant presents with one episode of urinary tract infection. The patient responds well to treatment and urinalysis reveals E. coli as the causative organism. There is no family history of ureteric reflux or renal disease. According to NICE guidelines, what imaging test(s) should be recommended? Urgent urinary tract ultrasoundRoutine urinary tract ultrasound within 6 weeksRoutine urinary tract ultrasound with DMSA within 4–6 monthsRoutine urinary tract ultrasound, DMSA and micturating cystourethrogramMagnetic resonance cystourethrogram
Truth or dare: switching BRAF/MEK inhibitors after acute interstitial nephritis in a patient with metastatic melanoma – A case report and review of the literature
Published in Acta Clinica Belgica, 2023
Lore De Ryck, Sigurd Delanghe, Celine Jacobs, Sharareh Fadaei, Lieve Brochez, Michael Saerens
However, 8 days later (week 23), he developed a grade 3 AKI (serum creatinine 3.34 mg/dL, eGFR 20.3 mL/min/m2) for which he was hospitalized. His urea was 90 mg/dL, his bicarbonate 21.4 mmol/L and he had a mild hypoalbuminemia of 61 g/L combined with a mild anaemia of 11.8 g/dL; white cell count was normal in the absence of eosinophilia (although the patient was already under treatment with corticosteroids at that time). CRP was markedly increased (72 mg/L) His liver function tests and other electrolytes were unremarkable. He did not present with a rash. Urinalysis revealed an isolated sterile pyuria (102/µL) and slight proteinuria (0.43 g/g creatinine). Urinary tract ultrasound was normal and excluded postrenal causes, lithiasis and renovascular impairment. Infectious and auto-immune workup (ANF, ANCA anti-GBM.) were all negative. He had not taken any other possible nephrotoxic medications, and he did not have any recent exposure to contrast. D + T were suspended, methylprednisolone was maintained at 16 mg and intravenous fluids were initiated at 125 mL/H. A kidney biopsy was performed, and the pathologic examination revealed diffuse interstitial inflammation, associated with moderate tubulitis and <10% tubular atrophy (Figure 2). No significant glomerular changes were observed lightmicroscopically. Immunofluorescence was negative and electron microscopy showed no deposits. These findings were consistent with AIN and – to a lesser extent – acute tubular injury.
Is extracorporeal shockwave lithotripsy (SWL) still suitable for >1.5 cm intrarenal stones? Data analysis of 1902 SWLs
Published in Scandinavian Journal of Urology, 2021
Wilmar Azal Neto, Enzo Morales, Marina Joseane Pachecco, Renato Nardi Pedro, Leonardo O. Reis
From December 2009 to December 2018 a total of 4130 SWL were performed at an outpatient Lithotripsy Center with a devoted operating room and staff in the interior of São Paulo State, Brazil. The center is a referral for more than 16 counties, and all patients referred to it had been seen by the respective county’s general urologist and had undergone laboratory and image workup with kidney, ureter and bladder (KUB) radiography and urinary tract ultrasound (US). A dedicated radiologist performed and reported the US and KUB stone size by the largest diameter.