2    A 61-year-old female with an incidentally discovered renal mass undergoes an abdominal MRI. Which finding on T1-weighted dual-echo gradient-recalled echo (GRE) imaging at 1.5 Tesla is most indicative of a benign histology?

  3    A 52-year-old male with autosomal dominant polycystic kidney disease presents with 12 hours of anuria and abdominal pain postoperative day 1 status post renal transplantation. Which of the following is the most likely explanation for the spectral waveform?

  4    A 50-year-old male with hematuria and a renal transplant presents for Doppler imaging. What is the most likely explanation for the finding in the lower pole?

  5    A 49-year-old male with an incidentally discovered renal mass undergoes a multiphasic renal mass protocol CT. This demonstrates a solitary exophytic 5.5-cm hypervascular heterogeneous solid right renal mass that lacks macroscopic fat and has a central scar. Which of the following is most correct?

  6    A 34-year-old female with numerous small solid echogenic renal masses undergoes a set of screening examinations. Which of the following studies is most likely to have been obtained in this patient?

  7    A 42-year-old male with diabetes mellitus type I complicated by end-stage renal disease undergoes a renal transplant. A percutaneous renal biopsy is performed 6 months later due to an elevated serum creatinine, and a subsequent renal ultrasound demonstrates an intrarenal arteriovenous fistula. What spectral Doppler waveform is characteristic of this entity?

  8    A 67-year-old male with a solid right renal mass undergoes percutaneous biopsy confirming clear cell renal cell carcinoma. Which artifact best explains the finding within the mass on T1-weighted dual-echo gradient-recalled echo (GRE) imaging at 1.5 Tesla?

  9    A 60 year-old male with malaise and weight loss presents for contrast-enhanced CT, which demonstrates multiple bilateral non–contour-deforming low-attenuation renal masses (30 to 50 Hounsfield units). They are confirmed to be solid on MRI. Which of the following is the most likely diagnosis?

  10    A 37-year-old female is found to have an incidental cystic renal mass. The highest attenuation component measures 180 Hounsfield units on postcontrast imaging (below) and 30 Hounsfield units on unenhanced imaging (not shown). What is the most appropriate Bosniak classification?

  11    A 30-year-old female with chronic urolithiasis and multiple prior CT studies (one of which, performed 3 years ago, is shown below) presents with flank pain and hematuria. A renal stone CT is ordered. What is the best way to ensure that the radiation dose be as low as reasonably achievable (ALARA)?

  12    A 59-year-old female with hypertension treated with two oral medications has the following incidental finding. What is the best next step?

  13    A 43-year-old female undergoes a multiphasic renal mass protocol CT of the abdomen demonstrating a 1.4-cm right renal mass. The attenuation measurements are 32 Hounsfield units on unenhanced images and 50 Hounsfield units on postcontrast images. An MRI is then obtained and is shown below. Given the MR findings, what is the best explanation for the measured attenuation difference on the unenhanced and postcontrast CT images?

  14    A 40-year-old female with recalcitrant hypertension undergoes CT angiography of the renal arteries. Which of the following would be treated best with balloon angioplasty alone?

  15    A 59-year-old male with urosepsis and hypotension presents with 6 hours of absent urine output. A renal Doppler study is performed. Which of the following spectral Doppler waveforms is most characteristic of acute tubular necrosis?

  16    A 62-year-old male with hematuria is found to have a large left renal mass. Which risk factor has the strongest association with the imaging findings?

  17    In which retroperitoneal space is the fluid collection predominantly located?

  18    A 45-year-old male was involved in a motor vehicle collision, and his left kidney was lacerated. Two weeks later, a contrast-enhanced CT was performed for persistent abdominal pain. What late-term complication is most strongly associated with the depicted abnormality?

  19    A 55-year-old female undergoes an unenhanced CT of the abdomen demonstrating a renal mass that measures 62 Hounsfield units. There are no comparison studies. What is the best next step?

  20    A 2-year-old girl with abdominal swelling and pain undergoes a CT of the abdomen and pelvis. Which of the following organisms most likely colonizes this patient’s urinary tract?

  21    A 52-year-old male presents with flank pain and dysuria, and a CT is performed 120 seconds after intravenous contrast material administration. Which of the following best describes the imaging finding in the left kidney?

  22    A 62-year-old male smoker with chronic obstructive pulmonary disease, coronary artery disease, hypertension, and peripheral vascular disease undergoes a CT angiogram of the abdomen and pelvis that demonstrates a 1.8-cm indeterminate homogeneous low-attenuation left renal mass (35 Hounsfield units). A renal mass protocol MRI is performed. What is the most likely explanation for the imaging findings?

  23    A 76-year-old patient with back pain undergoes a digital subtraction angiogram of the left kidney. What is the best next step?

  24    A 52-year-old male with biopsy-confirmed pancreatic adenocarcinoma undergoes a pancreaticoduodenectomy. During the postoperative course, a complication is suspected, and a contrast-enhanced CT of the abdomen is performed (shown below). Which of the following is the most specific imaging sign of acute renal infarction?

  25    A 51-year-old male with diabetes mellitus type II presents with right flank pain and dysuria. He has not seen a physician in many years. What is the best next step?

  26    A 52-year-old female presents with acute right flank pain. A contrast-enhanced CT is performed. Which of the following risk factors is most likely to be present in this patient?

  27    A 1-month-old infant presents with abnormal kidneys. Which of the following structures is likely to be also involved by this disease?

  28    A 62-year-old male with diabetes mellitus type II, benign prostatic hypertrophy, and urinary retention presents with a 2-cm ill-defined left renal mass that is new since a comparison CT 6 months ago. Following a 2-week course of antibiotics, the imaging is repeated, demonstrating persistence of the finding. The mass enhances 30 Hounsfield units. What is the best next step?

  29    A 54-year-old male with no significant past medical history presents with fever, leukocytosis, tachycardia, hypotension, and dysuria. What is the definitive management for this condition?

  30    A 60-year-old male presents for a contrast-enhanced CT of the abdomen, and an abnormality is noted in the kidneys. Which of the following is most strongly associated with this finding?