Abd (urinary tract)

Question 1

Vasculature Branching Order

Answer 1

• main renal a. @ hilum
• segmental
• interlobar
• arcuate
• interlobular

Question 2

Are the kidneys intra or retro?

Answer 2

-retroperitoneal

Question 3

Kidney Size in Adults

Answer 3

• 9 to 12 cm L
• 4 to 5 cm W
• 2.5 to 3 cm AP

Question 4

What should cortical thickness be?

Answer 4

• min. 1 cm

- < 1cm indicated renal disease

Question 5

Functions of Kidneys

Answer 5

• produce hormones
• absorbs minerals
• filters blood
• produces urine
• balances water (autoregulatory)
• acid regulation

Question 6

What hormone regulates BP?

Answer 6

-renin

Question 7

What hormone regulates blood cells and stimulates bone marrow to produce more RBC’s?

Answer 7

-erythropoeitin

Question 8

Normal Creatinine

Answer 8

0.6-1.2 mg/dL

Question 9

What is Creatinine?

Answer 9

• waste product produced from meat protein and normal wear and tear on muscles
• more specific in determining renal dysfunction than BUN

Question 10

When is creatinine elevated?

Answer 10

• renal failure
• chronic nephritis
• urinary obstruction

Question 11

Normal BUN Level

Answer 11

11-23 mg/dL

Question 12

What is BUN produced from?

Answer 12

-breakdown of food proteins

Question 13

When is BUN elevated?

Answer 13

• urinary obstruction
• renal dysfunction
• dehydration

Question 14

When is BUN decreased?

Answer 14

• overhydration
• pregnancy
• liver failure
• decrease in protein intake
• smoking

Question 15

Microscopic Hematuria

Answer 15

• visible microscopic RBC’s in urine under a microscope

- associated with early renal disease

Question 16

Macroscopic Hematuria

Answer 16

• visible with naked eye

- associated with infection and bladder neoplasms

Question 17

Proteinuria

Answer 17

-abnormal amount o protein in urine

Question 18

What is proteinuria associated with?

Answer 18

nephritis

• nephrolithiasis
• carcinoma
• polycystic disease
• hypertension
• diabetes mellitus
• increase risk of renal dysfunction

Question 19

Indications for US

Answer 19

• increased creatine, BUN, proteinuria
• urinary tract infection
• flank pain
• hematuria
• hypertension
• decreased urine output
• trauma
• evaluate mass from other imaging (CT)

Question 20

3 Sets of Kidneys in Embryo

Answer 20

• pronephros
• mesonephros
• metanephros

Question 21

Pronephroi Kidneys

Answer 21

• early 4th week gestation
• rudimentary
• non functioning

Question 22

Mesonephroi Kidneys

Answer 22

• late in 4th week

- function as interim kidneys

Question 23

Metanephroi Kidneys

Answer 23

-permanent kidneys

Question 24

Anomalies Related to Growth

Answer 24

• hypoplasia
• fetal lobulation
• compensatory hypertrophy

Question 25

Anomalies Related to Ascent

Answer 25

- ectopia - crossed renal ectopia - horseshoe

Question 26

Hypoplasia

Answer 26

- too few nephrons in a small kidney** - rare - incidental finding - unilateral (no symptoms) - bilateral (renal insufficiency)

Question 27

Anomalies Related to Uretral Bud

Answer 27

- agenesis - congenital megacalicies - congenital megaureter - supernumerary kidney - duplex collecting system and retrocedes - uretropelvic junction obstruction

Question 28

Uretropelvic Junction Obstruction

Answer 28

- common anomaly - caused by kink - stones, infection, impaired function - may be bilateral - ballooning of pelvis - 2:1 male:female ratio

Question 29

Bladder Agenesis

Answer 29

- rare - most infants are stillborn - surviving infants are female - many associated anomalies are present - bladder absent on fetal US

Question 30

3 Types of Bladder Duplication

Answer 30

1) complete/incomplete peritoneal fold separates 2 bladders 2) complete/incomplete septum divides bladder (may be multiple septa) 3) transverse band of muscle divides bladder into 2 unequal parts

Question 31

Bladder Extrophy

Answer 31

- 1 in 30 000 live births - 2:1 male:female ratio - congenital absense of lower abdomen and anterior bladder wall - associates with other anomalies - increased incidence of bladder carcinoma

Question 32

Abberent Vessels

Answer 32

- vascular anomaly - during embryology, kidney receives blood from high levels of AO - abberent renal arteries will be present if supply from lower levels persists - compress the ureter

Question 33

Retrocaval Ureter

Answer 33

- rare vascular anomaly - 3:1 male:female ratio - if infrarenal IVC does not develop from the supra cardinal vein, the ureter will pass posterior to IVC