ABD 2 — Renal/Urinary

Question 1

What kidney disease is incompatible with life?

Answer 1

Bilateral infantile polycystic kidney disease

Question 2

What is a differential diagnosis for renal parapelvic cysts?

Answer 2

Hydronephrosis

Question 3

Mrs. Wilson is a 52 year old male that was in for a right upper quadrant ultrasound. An echogenic mass was found on the right kidney. This area was later biopsied and found to be benign. What is the most likely diagnosis?

Answer 3

Angiomyolipoma

Question 4

What is the most common renal cancer seen in children under the age of 8 years?

Answer 4

Nephroblastoma

Question 5

Which artifact may assist the sonographer in identifying renal calculi?

Answer 5

Comet tail/twinkle

Question 6

What is the first step into differentiating a renal lesion?

Answer 6

Determine if it is cystic or solid

Question 7

What is the most likely cause of small, bumpy, echogenic kidneys with visible scarring and parenchymal thinning?

Answer 7

Chronic pyelonephritis

Question 8

What is the usual cause of acute tubular necrosis?

Answer 8

Renal ischemia

Question 9

What laboratory value, if elevated, would be an indication of obstructive uropathy?

Answer 9

BUN and serum creatinine

Question 10

Your next patient is a 70-year-old Caucasian male with a long history of using pain medications and tobacco products. He is complaining of mild flank pain and noticed blood in his urine this morning. The image below is what your found while scanning. What is the most likely diagnosis?

Answer 10

Transitional cell carcinoma (TCC)

Question 11

T/F

With ball type lesions, the contour of the kidney remains intact.

Answer 11

False

Question 12

The RUQ image below was found while scanning a female patient in ICU. She is a long standing diabetic which she poorly manages. She has an E.Coli infection and is septic. What is the most likely diagnosis?

Answer 12

Emphysematous pyelonephritis

Question 13

What is an intrinsic cause of unilateral hydronephrosis?

Answer 13

Urolithiasis

Question 14

What benign mass is impossible to differentiate from renal cell carcinoma in adults?

Answer 14

Adenoma

Question 15

The thickness of the bladder wall should not be more than ______________ in a patient with a nondistended bladder

Answer 15

5 mm

Question 16

A benign tumor of glandular epithelial tissue seen sonographically at the posterior portion of the bladder wall is descriptive of a…

Answer 16

Bladder adenoma

Question 17

T/F

Eighty percent of ureteral stones get lodged at the ureterovesical junction.

Answer 17

True

Question 18

Developmental anomaly resulting in multiple renal cysts of varying sizes and fibrosis of the affected kidney is…

Answer 18

Multicystic dysplastic kidney disease

Question 19

Autosomal recessive inherited disorder characterized by abnormal proliferation and dilation of renal tubules resulting in multiple microscopic cysts bilaterally is…

Answer 19

Infantile polycystic kidney disease

Question 20

Development of multiple renal macrocysts in the native kidneys of chronic renal failure patients.

Answer 20

Acquired cystic kidney disease

Question 21

The image below is from Mrs. Smith’s renal ultrasound. She is a 47 year old female with known hyperparathyroidism and Cushing’s syndrome. What is the most likely diagnosis for her?

Answer 21

Nephrocalcinosis

Question 22

***Written!

Mr. Finley is a 68 year old male with long standing hypertension and diabetes mellites. His lab work reveals an elevated BUN and creatinine. Give a detailed description of the kidney and tell me what you think his renal diagnosis is (do not give me hypertension or diabetes). You need to type the description as if it were your “tech notes” at the end of the exam.

Answer 22

Right kidney: atrophic (8.5 x 3.2 cm), posterior acoustic shadowing, cortical thinning (0.7 cm), appears diffusely hyperechoic to adjacent liver.

Possible chronic kidney disease

Question 23

What type of renal mass of the proximal tubular cells is the second most common solid mass and has a distinct echo pattern in the center?

Answer 23

Oncocytoma

Question 24

T/F

Acute pyelonephritis affects females significantly more than males and at ages 15-30 years old

Answer 24

True

Question 25

Mr. Stevens is a 44 year old patient that suffers from chronic hypertension and renal failure. He is in the department today for his semi-annual ultrasound. On today's exam you find the right kidney to look like the image below, which is almost identical to the left kidney. The right measures 16.5 cm in length and the left is 17.2 cm in length. What is his diagnosis most likely?

Answer 25

Adult polycystic kidney disease

Question 26

***Written Focal concentrations of certain substances make up urolithiasis. List 2 of them

Answer 26

Uric acid Calcium (Bonus: cystine)

Question 27

Ms. Nelson is a 32 year female that is presenting to the emergency room. She was recently diagnosed with lupus and is experiencing nausea/vomiting and fever. Her labs revealed an elevated BUN and creatinine. You did an abdominal ultrasound and found the image below. What renal pathology does this most likely represent?

Answer 27

Acute glomerulonephritis

Question 28

T/F Renal cell carcinoma is more frequently found in males than in females

Answer 28

True

Question 29

T/F Renal infarctions may appear sonographically as solitary or multiple oval shaped defects.

Answer 29

False

Question 30

Mets to the bladder is primarily done via this method:

Answer 30

Direct invation.

Question 31

This pediatric benign parenchymal tumor is the most common solid tumor in infants, what is it?

Answer 31

Mesoblastic nephroma

Question 32

T/F Medullary sponge kidney is dysplastic microcystic dilation of the medullary and papillary portions of the collecting tubules that cause the echogenicity of the area to become increased. This may be bilateral, unilateral, or may affect a single pyramid within the kidney.

Answer 32

True

Question 33

Impairment of the renal function can be due to numerous factors. Which factors are the most common cause of renal failure?

Answer 33

Renal factors

Question 34

A mass that was later diagnosed as transitional cell carcinoma was found in the mid portion of the right ureter. Which portion of the collecting system would you expect to see dilation?

Answer 34

Upper portion of the right ureter.

Question 35

The term “putty kidney” is associated with:

Answer 35

Chronic urinary tuberculosis

Question 36

***Written Name 3 different bean shaped lesions:

Answer 36

Lymphoma Transitional cell carcinoma Renal cell carcinoma

Question 37

***Written Describe 3 different false positive findings for hydronephrosis.

Answer 37

1. When the patients bladder is overdistended from being over-hydrated and hasn’t voided, making the collecting system appear falsely dilated and thus making it falsely appear like hydronephrosis. 2. When the patient has a parapelvic cyst, it can falsely look like hydronephrosis because the cyst is located in/near the renal sinus which can resemble dilated calyces. 3. When the patient has an extrarenal pelvis, which is when the renal pelvis lies outside the renal hilum. This can appear as a fluid-filled structure near the renal hilum, which can falsely mimic hydronephrosis.