ABD Board-Renal Flashcards
1
Q
normal anatomy of kidneys
A
retroperitoneal, lying against the deep muscles of the back
right is slightly inferior than the left
2
Q
adrenal gland is located in relation to the kidneys
A
superior medial to the kidneys
3
Q
liver is located in relation to the kidneys
A
superior lateral
4
Q
right colic flexure is loacted in relation to the kidneys
A
inferior
5
Q
2nd portion of the duodenum is loacted in relation to the kidneys
A
medial
6
Q
pancreatic tail is located in relation to the lt kidney
A
anterior to the upper pole
7
Q
left colic flexure is located in relation to the left kidney
A
inferior
8
Q
the diaphragm, psoas muscle, and the quadratus lumborum muscle are on the ______ aspect of the kidneys
A
posterior
9
Q
hilum of the kidney
A
vein-extends anteriorly
artery-enters between vein and ureter
ureter-exits posteriorly
10
Q
echogenicity of kidneys
A
cortex-isoechoic or hypoechoic
medullary pyramids-anechoic
renal sinus-hyperechoic
11
Q
normal measurement for renal cortex
A
= or > 1cm
from sinus to capsule
12
Q
inner portion of the kidney from base of pyramids to center of kidney
A
renal medulla
13
Q
inner hyperechoic portion of kidney which contains fat, calyces, renal pelvis, connective tissue, renal vessels, and lymphatics
A
renal sinus
14
Q
collecting tubules between cortex and sinus
A
pyramids
15
Q
funnel shaped transition from the major calyces to the ureter
A
renal pelvis
16
Q
medial opening for enty and exit of arter vein and ureter
A
hilum
17
Q
3 extensions for the renal pelvis
A
major calyces
18
Q
extensions of the major calyces that collects urine from the medullary pyramids
A
minor calyces
19
Q
apex of the medullary pyramids
A
renal papilla
20
Q
fibrous shealth enclosing kidney and adreanal glands, AKA perirenal space
A
gerotas foscia
21
Q
functional unit of kidney consisting of the renal corpuscle, proximal convoluted tubule, descening and ascending libs of henles loop, distal convuluted tubule, and collecting tubules
A
nephron
22
Q
consists of glomerulus and glomerular capsule (bowmans capsule)
A
renal corpuscle (malpighian body)
23
Q
at the hilum the main renal artery divides into
A
5 segmental arteries
24
Q
between the medullary pyramids, the segmental arteries divide into the
A
interlobar arteries (travel perpendicular to the renal capsule)
25
at the base of the med pyramids, the ____ _______ branch from the interlobar arteries
arcuate (parallel to renal capsule)
26
smallest arteries that branch off the arcuate arteries
interlobular arteries (run perpendicular to renal capsule)
27
order of renal arteries
```
main renal artery
to
segmental
to
interlobar
to
arcuate
to
interlobular
```
28
congenital anomalies of the genitourinary tract are ___ _____ than any other organ system
more common
29
there is an increases incidnece of what for an ectopic (pelvic) kidney
UPJ obstruction, ureteral reflux, and multicystic renal dysplasia
30
horseshoe kidney
most common
lower poles connect across the midline anterior to the ao
lies lower cause the ascent is prevented by the inferior mesenteric artery
31
the isthmus of the horseshoe kidney can be mistaken for ______ and the ureters are _____ to the isthmus
lymphadenopathy
anterior
32
kidneys fuse in the pelvis and one ascends to normal place carrying other one with it crossing the midline, two ureters on each side of the bladder one crossing midline
crossed fused renal ectopia
33
kidneys fuse to form a round mass in pelvis known as a discoid or pancake kidney
fused pelvic kidney
34
common cortical thickening on the lateral aspect of lt kidney
dromedary hump
35
partial fusion of the renunculi (embryonic kidney)
triangular hyperechoic area on anterior aspect of upper pole of rt kidney
junctional parenchymal defect AKA fetal lobulation
36
duplication of collecting system
complete central cortical break within the hyperechoic sinus
duplex kidney
complete 2 ureters
incomplete 1 ureter
37
complete with 2 ureter complication of ectopic insertionn of ureter
ureterocele, prolapse of distal ureter into bladder resulting in hydroureter and hydronephrosis of upper collecting system of the kidney (weigert meyer rule)
38
prominant renal cortical parenchyma located between 2 medually pyramids. gives appearance of mass
column of bertin (septal cortex)
39
renal pelvis lies outside the renal sinus appearing as a cystic collection medial to the renal hilum
extrarenal pelvis
40
common cause of urinary obstruction in the male neionatal patient
obstruction is due to a flap of mucosa that has a slit like opening in the area of the prostatic urethra
posterior uretheral valve (PUV)
large bladder
hydroureter
hydronephrosis
urinoma
41
most renal cysts are
simple cortical cysts that originate from obstructed uriniferous tubules
42
calyceal diverticula that appear as a simple cyst
pylogenic cyst
43
cortical cysts that bulge into the central sinus
parapelvic cysts,
44
lymphatic cysts in the central sinus
peripelvic cysts
45
renal cycsts located in the periphery of the kidney (outside)
cortical or parechymal cysts
46
renal cysts located in the center (renal sinus) of the kidney
peripelvic cysts
47
associations with simple benign renal cysts
single thin septation
minimal wall calcification
internal echoes caused by artifact
lobulated shapes
48
association with malignant renal cyst
miltiple or thick spetation
thick cacification
mural nodule/solid componenet
49
defines imaging characteristic that relate to increased chances of malignancy
bosniak renal cyst classification
50
bilateral renal enlargement due to the development of numerous custs of varying sizes
autosomal dominanay (adult) polycystic kidney disease
51
autosomal dominant polycystic kidney disease is associated with cysts in the
liver
panc
spleen
52
autosomal dominanat polycycstic kid disease can cause
destruction of the residual renal tissue in advanced stages leads to renal failure and hypertension
53
autosomal dominant polycystic renal disease is associated with
arterial aneurysms especially cerebral artery (berry) aneurysms of the circle of willis
54
infantile polycystic kidney disease
autosomal recessive
55
autosomal recessive (infantile) polycystic kidney disease appearance
enlarged kidneys bilateral
hyperechoic parenchyma
loss of cortical medullary distinction
56
polycystic autosomal recessive kidney disease is assocated with
renal dysfunction
pulmonary hypoplasia (due to oligo)
congenital hepatic dibrosis
portal hypertension
57
typpical appearance of neonate as a direct result of oligo and compression while in utero
potter syndrome
58
most cmmon cause of an abdominal mass in newborns
form of renal dysplasia characterized by multople noncommunicating cysts with the absence of renal parenchyma. Result of atresia of the ereteropelvic junction during development. Usually unilateral
multicystic dysplastic kidney
59
ureteropelvic junction obstruction is caused by
ureteral hypoplasia
high insertion of ureter into renal pelvis
compression by segmental artery
60
UPJ is associated with
multicystic dysplastic kidney
renal agenesis
duplicated collecting system
horseshoe kidney
ectopic kidney
61
congenital dysplastic cystic dilatation of the medullary pyramids due to tubular ectasia or dysplasia
due to urinary statsis, calcium deposits form in dilated tubules
medullary sponge kidney
62
development of multiple cysts in chrinically failed kidneys during long ter hhemodialysis
acquired cistic disease
63
inherited disease which usually presents in the second to third decade of life with serious visual iimpairment
characterized by retinal and central nervous system hemangioblastomas, and related tumors
von hippel lindau disease
64
related tumors for von hippel lindau disease
renal cell carcinomas
pheochromocytomas
hemangioblastomas
65
hyperechoic benign renal rumor with echogenicity greater than or = to that of the renal sinus
angiomyolipoma
propagagtion speed artifact due to fat
80% involve the rt kidney
66
multi system genetric disease, increased incidence of renal cysts and angiomyolipomas(usually bilateral with this)
tuberous sclerosis
patient presentation seizures, mental retardation, and facial angiofibromas
67
most common solid renal mass in adult. usually unilateral encapsulated mass, nephrectomy is recommended
renal cell carcinoma
hypoechoic relative to the normal adjacent renal parenchyma
68
symptoms of renal cell carcinoma
heaturia
flank pain
weight loss
flank mass
fever
hypertension
hypercalcemia
males-varicoceles due to occlusion of the gonadal vein
69
common tumor extension with renal cell carcinoma
renal veins and IVC
70
increased incidence for renal cell carcinoma with
acquired cystic desease
Von hippel lindau syndrome
tubersous sclerosis
ADPKD
71
appearance of renal metastases
hypoechoic masses
diffusely enlarged inhomogeneous kidney
72
most common childhood renal rumor
nephroblastoma
destroys renal contour
73
nephroblastoma AKA
wilms tumor
74
if normal renal contour is maintained bilaterally in child with ABD mass it is most likely
adrenal neuroblastomas
75
most renal infections occur via an
ascending route from the bladder
76
acure pyelonephritis
renal infection
77
appearance of pyelonephritis
renal enlargement
hypoechoic parenchyma
absence of sinus echoes
78
acute focal baterial nephritis or lobar nephronia
focal acute pyelonephritis
79
bacterial infection associated with renal ischemia
emphysematous
intrarenal gas causes comet tail (reverberation) artifact
usually needs nephrectomy
80
renal injury induced by recurrent renal infection due to anatomic anomalies, obstructive lesions, or ureteral reflux
chronic pyelonephritis
81
appearance of chronic pyelonephritis
small hyperechoic kidney with corical thining
82
chronic phelonephritis resulting from chronic infections due to long term obstruction
xanthogranulomatous pyelonephritis (XGPN)
staghorn with irrecgular kidney will be this
83
one stone connected together
staghorn calculus
84
purulent(consisting of, containging, or draining ous) material in the collection system of the kidney associated with an infection secondary to renal obstruction
pyonephrosis
will see hyperechoic debris in a dilated renal collecting system
85
most common renal fungal disease
candidiasis
86
hyperechoic nonshadowing mass
mycetoma (Fungal ball)
87
abrupt decline in renal function manifested by decreased urunary output and elevation in plasma bloos urea nitrogen (BUN) and serum creatinine
acute kidney injury (AKI) used to be called acute kidney failure (AKF)
88
dilated thrombosed renal vein
absent intrarenal venous flow
enlarged hypoechoic kidney
high resistence renal artery**
renal vein thrombosis
89
focal hypoechoic areas of infact
absence of intrarenal arterial flow
renal enlargement
acute flank pain
hematuria
sudden rise in blood pressure
renal artery thrombosis
90
most common cause of acute kidney injury/failure
acute tubular necrosis
caused by prolonged ischemia or nephrotixins (drigs and contrast agents) causing damage to the tubular epithelium of the nephron
91
appearance of acute tubular nephrosis
renal enlargement
increased resistive index
92
inflammaroty resonse resulting in glomerular damage caused by infectious and noninfectious causes
acute glomerulonephritis
enlargement and increased resistive index
93
a threshold resistive index of > than ____ suggestive of obstructive hydonephrosis
0.7
94
wide ureter > than 7mm in diameter
megaureter
mostly males and on the rt side
95
disorders of calcium metabolism resulting in the formation of calcium renal stones and deposistion of calcium in the renal parenchyma
nephrocalcinosis
most common cause is hyperparathyroidism
96
ischemia of the medullary pyramids
papillary necrosis
will find sloughed papillae in urine tract causing obstruction
97
increrased renal sinus fat that replaces normal renal parenchyma
renal sinus lipomatosis
98
the baldder is connected to the umbilicus by the
median umbilical ligament (urachus)
99
the ureters enter the bladder at the
superolateral angle of the trigon
| exit via urethra
100
normal bladder wall thickness is (distended and nondistended)
distended
101
most acquired bladder diverticula are associated with longstanding bladder outlet obstuction due to
benign prostatic hypertrophy
102
dilatation of the fetal urachus which is the medium umbilical ligament connecting the bladder to the umbilicus.
urachal cyst
103
the ureters exit the kidney
posterior to the renal artery and vein
104
the ureters lie on the
anterior surface of the psoas in the pelvis
105
the ureters cross ____ to the common iliac vessels to insert upon the trigone
anterior
106
a cyst like enlargement of the lower end of the ureter which projects into the bladder lumen at the ureterovesical junction
ureteroceles
107
ureteroceles are most commonly found in association with
complete ureteral duplication
108
most common bladder neoplasm (can occur in ureters and renal pelvis too but mostly bladder)
transitional cell carcinoma
109
urinary tract in lined with
tansitional cells
110
appearance of transitional cell carcinoma
solid mass or focal thickening of the bladder wall
hematuria (most common symptom)
111
transitional cell carcinoma originating in the ___ will cause hydronephrosis
ureter
112
bladder masses
transitional cell carcinoma
cystitis
prostate cancer
squamous cell cancer
blood clots
pyogenic debris
bladder papilloma
113
RI =
peak systomlic freq - end diastolic freq / peak systolic freq
114
normal renal artery RI
115
restive index is a value comparing the amount of diastole to that of the systole. It is a relative value (no units) that can be measured in freq or velocity
if the RO = 0.5 (diastole is 50% od systole)
if the RI = 0.7 (diastole is 30% of systole)
if the RI = 1.0 (diastole is absent)
116
symptoms of renal artery stenosis are
sudden onset o hypertension
uncontrollable hypertension
117
parvus tardus
indirect renal artery stenosis evaluation
slow pulse
absent early systolic peak
118
direct renal artery stenosis evaluation
renal artery / Aorta ratio = Renal artery ratio > 3.5
119
normal intrarenal waveform (indirect) evaluatioin will have
early systolic peak
looks like a small charp spike in begining of waveform
120
the ___ kidney is favored for harvesting in a transplant due to its _____
left
longer renal vein
121
the anastomosis in a transplanted kidney is usually
with the external or internal iliac artery
122
poor functioin of renal transplant may be due to
acute tubular necrosis in the immediate pottransplantation period
123
post renal transplant complications include
hematomas (24 hours post op)
urinomas (24 hours post op)
lymphoceles
abscesses ( 2 to 3 weeks post op)
renal artery kinking or thrombosis
renal vein thrombosis
124
appearance of rejecting kidney
renal enlargement (length)
decreased echogenicity
loss of cortical medullary boundey
increasing flow resistance (resistive index)
125
normal serum creatinine levels
1.2 to 2.0 depending on skeletal muscle amouts
126
most common neonatal abd mass
multicystic kidneys
127
most common neonatal adreanal mass
adrenal hemorrage
128
most common shildhood adreanal mass
neuroblastoma
129
most common neonatal renal mass
multicystic displastic kidneys
130
most common childhood renal mass
wilms tumor
