GU/Breast/O&G/Endo – Autumn 2012
1. Renal mass with central scar – oncocytoma
2. Which MRI agent will cause nephrogenic systemic fibrosis – Dotarem, Omniscan, ProHance
3. 15 yr old girl with irregular periods, non sexually active, acute fever and pain and raised
BHCG – cystic mass with thick septa on 1 side only – Malignant granulose cell, torted
dermoid, torted malignant germ cell tumour, PID, ectopic
4. Feature least likely to be PCOS (has come up once before) - >12 cysts, enhancing stroma,
multiple small cysts of <10mm, cysts >3cm, large ovary 4cm
5. Best imaging for distinguishing cyst from urethral diverticulum – pelvic uss, abdo USS, MRI.
IVU, CT
6. Breast mass with lobulations and acoustic enhancement – Phylloides, epidermoid cyst
7. Inguinal node lymph node – FNA – turns out to be SCC - most likely primary, penile,
scrotum, testicular
8. New Transplant kidney, no flow in renal vein. Taken to theatre, no thrombus in RV – whay
no flow seen in renal vein? Incorrect angle correction, angle correction less than 60 degrees,
velocity too high, gain is too high
9. Incidental mass on CTin kidney, 4mm enhancing septa – which Bosniak type?
10. 48 year old lady – kidney contains low density areas between HU -10 to -15, low
enhancement, kidney enlarged, pyuria – XGP, acute PN, renal vein thrombosis, sarcoid, TB
11. Incidental calcifications in adrenal – most likely cause – histoplamosis, diabetes, TB,
Haemorrhage, Addison
12. Urinary cast and pyuria - ?cause
13. Trauma – blood at urethral meatus with bilateral pubic rami #. Best modality to investigate –
cystogram, ascending urethrogram, IVU, CT
14. Which is least likely to be ovarian met – sclerotic bone mets, left pleural effusion, ascites,
small bowel obstruction, peritoneal soft tissue deposit
15. What is the least likely location of metastatic kidney cancer – on other kidney, liver, lung,
sclerotic bone met
16. Tubular breast ca – fully treated 10 years ago, lymph node negative. Had renal transplant –
on high dose cyclosporine. Now contralateral lymph node in axilla – Tb, sarcoid, breat mets,
lymphoma, ALL
17. Features of seminoma on US – 2.5 cm solid mass
18. MR appearances of fibroids
19. Meigs syndrome – which cancer most likely cause – cystadenocarcinoma, cystadenoma,
fibroma
20. MR appearances of adenomyosis
21. Testicle- which feature would make it more likely to be infection over malignancyhydrocele, epidydimal involvement, increased vascularity of testicle, focal low density lesion
22. What feature of breast mass would make you think its a malignancy- echogenic halo, axillary
LN, solitary well defined mass, speculate mass, calcification
23. Triple test assessment – what re the components
24. What do you do with a 7mm papilloma in breast – repeat scan in 3/12, repeat scan in 6/12,
excision biopsy, vacuum biopsy, repeat mammogram
25. Pregnant woman 32 yrs old, with malignant looking breast mass what do u do ? mammo,
MR post partum, US guided biopsy
26. You have done a biopsy of a malignant looking mass – normal breat tissue only – what do
you do next – repeat biopsy, watch and wait, discharge
27. 49 year old with BRCA 1 – repeat mammo every 3/12, repeat mammo annually, US annually,
Breast MR and mammo yearly, MR yearly
28. Medullary sponge kidney
29. Reduced corticomeduallry differentiation- acute cortical necrosis, ATN,
30. Best phase for small masses – arterial, nephrogenic, corticomedullary, excretory, delayed
phase
31. Washout for >60% - adenoma
32. 55 year fat man, hypertension, reduced ACTH, mass which has focus of Ca- 3cm – phaeo,
myelolipoma, AML
33. 22 year old, anorexia, wt loss, anaemia, multiple low attenuation lesions HU 35 - ? cause –
NHL, Lymphoma, TB, RCC
34. Mass at upper pole of testes – multicystic with echogenic focus, - spermatocele, epidydimal
cyst, dilated rete
35. 44 year old with hypotension, tachycardia, no history of trauma. Mass lower pole of kidney,
multiple aneurysms – AML, RCC, ?VHL?
36. Young lady dilation and stenosis of renal arteries – FMD, PAN,
37. Hypertension 160/100 – starts ACEi and creat goes up – why ?ostial stenosis, FMD,
38. Woman, chronic pelvic pain 6/12, multiple serpigenous things – pelvic congestion, absent
IVC, thrombosis
39. Stabbed 3/52, sudden hypotension, mass in renal pelvis, enhances on arterial phase, renal
vein in normal – bleeding pseudoaneurysm, AVM
40. RCC inoperable mass, bleeding requiring treatment, mass invading renal vein, 6cm. – RV coil
embolisation,