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Miranda's Flash Cards > ABD Board-Renal > Flashcards

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

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2
Q

adrenal gland is located in relation to the kidneys

A

superior medial to the kidneys

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3
Q

liver is located in relation to the kidneys

A

superior lateral

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4
Q

right colic flexure is loacted in relation to the kidneys

A

inferior

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5
Q

2nd portion of the duodenum is loacted in relation to the kidneys

A

medial

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6
Q

pancreatic tail is located in relation to the lt kidney

A

anterior to the upper pole

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7
Q

left colic flexure is located in relation to the left kidney

A

inferior

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8
Q

the diaphragm, psoas muscle, and the quadratus lumborum muscle are on the ______ aspect of the kidneys

A

posterior

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9
Q

hilum of the kidney

A

vein-extends anteriorly

artery-enters between vein and ureter

ureter-exits posteriorly

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10
Q

echogenicity of kidneys

A

cortex-isoechoic or hypoechoic

medullary pyramids-anechoic

renal sinus-hyperechoic

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11
Q

normal measurement for renal cortex

A

= or > 1cm

from sinus to capsule

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12
Q

inner portion of the kidney from base of pyramids to center of kidney

A

renal medulla

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13
Q

inner hyperechoic portion of kidney which contains fat, calyces, renal pelvis, connective tissue, renal vessels, and lymphatics

A

renal sinus

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14
Q

collecting tubules between cortex and sinus

A

pyramids

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15
Q

funnel shaped transition from the major calyces to the ureter

A

renal pelvis

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16
Q

medial opening for enty and exit of arter vein and ureter

A

hilum

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17
Q

3 extensions for the renal pelvis

A

major calyces

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18
Q

extensions of the major calyces that collects urine from the medullary pyramids

A

minor calyces

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19
Q

apex of the medullary pyramids

A

renal papilla

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20
Q

fibrous shealth enclosing kidney and adreanal glands, AKA perirenal space

A

gerotas foscia

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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

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22
Q

consists of glomerulus and glomerular capsule (bowmans capsule)

A

renal corpuscle (malpighian body)

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23
Q

at the hilum the main renal artery divides into

A

5 segmental arteries

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24
Q

between the medullary pyramids, the segmental arteries divide into the

A

interlobar arteries (travel perpendicular to the renal capsule)

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25
Q

at the base of the med pyramids, the ____ _______ branch from the interlobar arteries

A

arcuate (parallel to renal capsule)

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26
Q

smallest arteries that branch off the arcuate arteries

A

interlobular arteries (run perpendicular to renal capsule)

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27
Q

order of renal arteries

A 
main renal artery
to
segmental
to
interlobar
to
arcuate
to
interlobular
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28
Q

congenital anomalies of the genitourinary tract are ___ _____ than any other organ system

A

more common

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29
Q

there is an increases incidnece of what for an ectopic (pelvic) kidney

A

UPJ obstruction, ureteral reflux, and multicystic renal dysplasia

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30
Q

horseshoe kidney

A

most common

lower poles connect across the midline anterior to the ao

lies lower cause the ascent is prevented by the inferior mesenteric artery

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31
Q

the isthmus of the horseshoe kidney can be mistaken for ______ and the ureters are _____ to the isthmus

A

lymphadenopathy

anterior

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32
Q

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

A

crossed fused renal ectopia

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33
Q

kidneys fuse to form a round mass in pelvis known as a discoid or pancake kidney

A

fused pelvic kidney

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34
Q

common cortical thickening on the lateral aspect of lt kidney

A

dromedary hump

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35
Q

partial fusion of the renunculi (embryonic kidney)

triangular hyperechoic area on anterior aspect of upper pole of rt kidney

A

junctional parenchymal defect AKA fetal lobulation

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36
Q

duplication of collecting system

complete central cortical break within the hyperechoic sinus

A

duplex kidney

complete 2 ureters

incomplete 1 ureter

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37
Q

complete with 2 ureter complication of ectopic insertionn of ureter

A

ureterocele, prolapse of distal ureter into bladder resulting in hydroureter and hydronephrosis of upper collecting system of the kidney (weigert meyer rule)

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38
Q

prominant renal cortical parenchyma located between 2 medually pyramids. gives appearance of mass

A

column of bertin (septal cortex)

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39
Q

renal pelvis lies outside the renal sinus appearing as a cystic collection medial to the renal hilum

A

extrarenal pelvis

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40
Q

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

A

posterior uretheral valve (PUV)

large bladder
hydroureter
hydronephrosis
urinoma

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41
Q

most renal cysts are

A

simple cortical cysts that originate from obstructed uriniferous tubules

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42
Q

calyceal diverticula that appear as a simple cyst

A

pylogenic cyst

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43
Q

cortical cysts that bulge into the central sinus

A

parapelvic cysts,

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44
Q

lymphatic cysts in the central sinus

A

peripelvic cysts

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45
Q

renal cycsts located in the periphery of the kidney (outside)

A

cortical or parechymal cysts

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46
Q

renal cysts located in the center (renal sinus) of the kidney

A

peripelvic cysts

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47
Q

associations with simple benign renal cysts

A

single thin septation

minimal wall calcification

internal echoes caused by artifact

lobulated shapes

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48
Q

association with malignant renal cyst

A

miltiple or thick spetation

thick cacification

mural nodule/solid componenet

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49
Q

defines imaging characteristic that relate to increased chances of malignancy

A

bosniak renal cyst classification

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50
Q

bilateral renal enlargement due to the development of numerous custs of varying sizes

A

autosomal dominanay (adult) polycystic kidney disease

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51
Q

autosomal dominant polycystic kidney disease is associated with cysts in the

A

liver

panc

spleen

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52
Q

autosomal dominanat polycycstic kid disease can cause

A

destruction of the residual renal tissue in advanced stages leads to renal failure and hypertension

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53
Q

autosomal dominant polycystic renal disease is associated with

A

arterial aneurysms especially cerebral artery (berry) aneurysms of the circle of willis

54
Q

infantile polycystic kidney disease

A

autosomal recessive

55
Q

autosomal recessive (infantile) polycystic kidney disease appearance

A

enlarged kidneys bilateral

hyperechoic parenchyma

loss of cortical medullary distinction

56
Q

polycystic autosomal recessive kidney disease is assocated with

A

renal dysfunction

pulmonary hypoplasia (due to oligo)

congenital hepatic dibrosis

portal hypertension

57
Q

typpical appearance of neonate as a direct result of oligo and compression while in utero

A

potter syndrome

58
Q

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

A

multicystic dysplastic kidney

59
Q

ureteropelvic junction obstruction is caused by

A

ureteral hypoplasia

high insertion of ureter into renal pelvis

compression by segmental artery

60
Q

UPJ is associated with

A

multicystic dysplastic kidney

renal agenesis

duplicated collecting system

horseshoe kidney

ectopic kidney

61
Q

congenital dysplastic cystic dilatation of the medullary pyramids due to tubular ectasia or dysplasia

due to urinary statsis, calcium deposits form in dilated tubules

A

medullary sponge kidney

62
Q

development of multiple cysts in chrinically failed kidneys during long ter hhemodialysis

A

acquired cistic disease

63
Q

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

A

von hippel lindau disease

64
Q

related tumors for von hippel lindau disease

A

renal cell carcinomas

pheochromocytomas

hemangioblastomas

65
Q

hyperechoic benign renal rumor with echogenicity greater than or = to that of the renal sinus

A

angiomyolipoma

propagagtion speed artifact due to fat

80% involve the rt kidney

66
Q

multi system genetric disease, increased incidence of renal cysts and angiomyolipomas(usually bilateral with this)

A

tuberous sclerosis

patient presentation seizures, mental retardation, and facial angiofibromas

67
Q

most common solid renal mass in adult. usually unilateral encapsulated mass, nephrectomy is recommended

A

renal cell carcinoma

hypoechoic relative to the normal adjacent renal parenchyma

68
Q

symptoms of renal cell carcinoma

A

heaturia

flank pain

weight loss

flank mass

fever

hypertension

hypercalcemia

males-varicoceles due to occlusion of the gonadal vein

69
Q

common tumor extension with renal cell carcinoma

A

renal veins and IVC

70
Q

increased incidence for renal cell carcinoma with

A

acquired cystic desease

Von hippel lindau syndrome

tubersous sclerosis

ADPKD

71
Q

appearance of renal metastases

A

hypoechoic masses

diffusely enlarged inhomogeneous kidney

72
Q

most common childhood renal rumor

A

nephroblastoma

destroys renal contour

73
Q

nephroblastoma AKA

A

wilms tumor

74
Q

if normal renal contour is maintained bilaterally in child with ABD mass it is most likely

A

adrenal neuroblastomas

75
Q

most renal infections occur via an

A

ascending route from the bladder

76
Q

acure pyelonephritis

A

renal infection

77
Q

appearance of pyelonephritis

A

renal enlargement

hypoechoic parenchyma

absence of sinus echoes

78
Q

acute focal baterial nephritis or lobar nephronia

A

focal acute pyelonephritis

79
Q

bacterial infection associated with renal ischemia

A

emphysematous

intrarenal gas causes comet tail (reverberation) artifact

usually needs nephrectomy

80
Q

renal injury induced by recurrent renal infection due to anatomic anomalies, obstructive lesions, or ureteral reflux

A

chronic pyelonephritis

81
Q

appearance of chronic pyelonephritis

A

small hyperechoic kidney with corical thining

82
Q

chronic phelonephritis resulting from chronic infections due to long term obstruction

A

xanthogranulomatous pyelonephritis (XGPN)

staghorn with irrecgular kidney will be this

83
Q

one stone connected together

A

staghorn calculus

84
Q

purulent(consisting of, containging, or draining ous) material in the collection system of the kidney associated with an infection secondary to renal obstruction

A

pyonephrosis

will see hyperechoic debris in a dilated renal collecting system

85
Q

most common renal fungal disease

A

candidiasis

86
Q

hyperechoic nonshadowing mass

A

mycetoma (Fungal ball)

87
Q

abrupt decline in renal function manifested by decreased urunary output and elevation in plasma bloos urea nitrogen (BUN) and serum creatinine

A

acute kidney injury (AKI) used to be called acute kidney failure (AKF)

88
Q

dilated thrombosed renal vein

absent intrarenal venous flow

enlarged hypoechoic kidney

high resistence renal artery**

A

renal vein thrombosis

89
Q

focal hypoechoic areas of infact

absence of intrarenal arterial flow

renal enlargement

acute flank pain

hematuria

sudden rise in blood pressure

A

renal artery thrombosis

90
Q

most common cause of acute kidney injury/failure

A

acute tubular necrosis

caused by prolonged ischemia or nephrotixins (drigs and contrast agents) causing damage to the tubular epithelium of the nephron

91
Q

appearance of acute tubular nephrosis

A

renal enlargement

increased resistive index

92
Q

inflammaroty resonse resulting in glomerular damage caused by infectious and noninfectious causes

A

acute glomerulonephritis

enlargement and increased resistive index

93
Q

a threshold resistive index of > than ____ suggestive of obstructive hydonephrosis

A

0.7

94
Q

wide ureter > than 7mm in diameter

A

megaureter

mostly males and on the rt side

95
Q

disorders of calcium metabolism resulting in the formation of calcium renal stones and deposistion of calcium in the renal parenchyma

A

nephrocalcinosis

most common cause is hyperparathyroidism

96
Q

ischemia of the medullary pyramids

A

papillary necrosis

will find sloughed papillae in urine tract causing obstruction

97
Q

increrased renal sinus fat that replaces normal renal parenchyma

A

renal sinus lipomatosis

98
Q

the baldder is connected to the umbilicus by the

A

median umbilical ligament (urachus)

99
Q

the ureters enter the bladder at the

A

superolateral angle of the trigon

exit via urethra

100
Q

normal bladder wall thickness is (distended and nondistended)

A

distended

101
Q

most acquired bladder diverticula are associated with longstanding bladder outlet obstuction due to

A

benign prostatic hypertrophy

102
Q

dilatation of the fetal urachus which is the medium umbilical ligament connecting the bladder to the umbilicus.

A

urachal cyst

103
Q

the ureters exit the kidney

A

posterior to the renal artery and vein

104
Q

the ureters lie on the

A

anterior surface of the psoas in the pelvis

105
Q

the ureters cross ____ to the common iliac vessels to insert upon the trigone

A

anterior

106
Q

a cyst like enlargement of the lower end of the ureter which projects into the bladder lumen at the ureterovesical junction

A

ureteroceles

107
Q

ureteroceles are most commonly found in association with

A

complete ureteral duplication

108
Q

most common bladder neoplasm (can occur in ureters and renal pelvis too but mostly bladder)

A

transitional cell carcinoma

109
Q

urinary tract in lined with

A

tansitional cells

110
Q

appearance of transitional cell carcinoma

A

solid mass or focal thickening of the bladder wall

hematuria (most common symptom)

111
Q

transitional cell carcinoma originating in the ___ will cause hydronephrosis

A

ureter

112
Q

bladder masses

A

transitional cell carcinoma

cystitis

prostate cancer

squamous cell cancer

blood clots

pyogenic debris

bladder papilloma

113
Q

RI =

A

peak systomlic freq - end diastolic freq / peak systolic freq

114
Q

normal renal artery RI

A
115
Q

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

A

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
Q

symptoms of renal artery stenosis are

A

sudden onset o hypertension

uncontrollable hypertension

117
Q

parvus tardus

indirect renal artery stenosis evaluation

A

slow pulse

absent early systolic peak

118
Q

direct renal artery stenosis evaluation

A

renal artery / Aorta ratio = Renal artery ratio > 3.5

119
Q

normal intrarenal waveform (indirect) evaluatioin will have

A

early systolic peak

looks like a small charp spike in begining of waveform

120
Q

the ___ kidney is favored for harvesting in a transplant due to its _____

A

left

longer renal vein

121
Q

the anastomosis in a transplanted kidney is usually

A

with the external or internal iliac artery

122
Q

poor functioin of renal transplant may be due to

A

acute tubular necrosis in the immediate pottransplantation period

123
Q

post renal transplant complications include

A

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
Q

appearance of rejecting kidney

A

renal enlargement (length)

decreased echogenicity

loss of cortical medullary boundey

increasing flow resistance (resistive index)

125
Q

normal serum creatinine levels

A

1.2 to 2.0 depending on skeletal muscle amouts

126
Q

most common neonatal abd mass

A

multicystic kidneys

127
Q

most common neonatal adreanal mass

A

adrenal hemorrage

128
Q

most common shildhood adreanal mass

A

neuroblastoma

129
Q

most common neonatal renal mass

A

multicystic displastic kidneys

130
Q

most common childhood renal mass

A

wilms tumor

Miranda's Flash Cards (14 decks)

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