Chapter 27 - The Neonatal and Pediatric Kidneys and Adrenal Glands

Question 1

occurs when the fetus is stressed during a difficult delivery or a hypoxic insult (lack of oxygen)

Answer 1

adrenal hemorrhage

Question 2

lie at the base of the medullary pyramids and appear as echogenic structures

Answer 2

arcuate arteries

Question 3

congenital polycystic kidney disease that usually presents during middle age; sometimes asymptomatic, the severity of the disease varies widely; presents with hypertension, hematuria, and enlarged kidneys; cysts can also form in the liver, spleen, and pancreas

Answer 3

autosomal dominant polycystic kidney disease (ADPKD)

Question 4

rare, congenital polycystic renal disease also known as infantile polycystic disease; typically presents with diffuse enlargement, sacculations, and cystic diverticula of the medullary portions of the kidneys

Answer 4

autosomal recessive polycystic kidney disease (ARPKD)

Question 5

most common benign renal tumor of the neonate and infant

Answer 5

congenital mesoblastic nephroma

Question 6

the outer rim of the kidney; the cortex is thin in the neonate, with an echogenicity similar or slightly greater than that of the normal liver parenchyma

Answer 6

cortex

Question 7

dilatation of any tubular vessel

Answer 7

ectasia

Question 8

occurs more commonly in females (on left side); ectopic insertion and cystic dilation of distal ureter of a duplicated renal collecting system

Answer 8

ectopic ureterocele

Question 9

dilation of the renal collecting system

Answer 9

hydronephrosis

Question 10

large and hypoechoic in the neonate

Answer 10

medullary pyramids

Question 11

most common cause of renal cystic disease in the neonate; multiple cystic masses within the kidney; may have contralateral ureteral pelvic junction obstruction

Answer 11

multicystic dysplastic kidney (MCDK)

Question 12

abnormal persistence of fetal renal blastema (potential to develop into Wilms’ tumor)

Answer 12

nephroblastomatosis

Question 13

malignant adrenal mass seen in pediatric patients; hemorrhaging tumor principally consisting of cells resembling neuroblasts

Answer 13

neuroblastoma

Question 14

poorly functioning enlarged kidneys

Answer 14

polycystic renal disease

Question 15

the presence of a valve in the posterior urethra; occurs only in male fetuses; most common cause of bladder outlet obstruction in the male neonate

Answer 15

posterior urethral valve

Question 16

classification of cystic renal disease

Answer 16

Potter facies

Question 17

dilation of the fetal abdomen secondary to severe bilateral hydronephrosis and fetal ascites; fetus also has oligohydramnios and pulmonary hypoplasia

Answer 17

prune belly syndrome

Question 18

underdevelopment of the lung tissue that occurs in utero secondary to oligohydramnios

Answer 18

pulmonary hypoplasia

Question 19

kidney becomes enlarged and edematous as a result of obstruction of the renal vein

Answer 19

renal vein thrombosis

Question 20

most common neonatal obstruction of the urinary tract; results from intrinsic narrowing or extrinsic vascular compression

Answer 20

ureteropelvic junction obstruction

Question 21

adds cardiac and limb anomalies to the VATER syndrome

Answer 21

VACTERL

Question 22

vertebral, anal, tracheoesophageal fistula, and renal anomalies

Answer 22

VATER

Question 23

most frequent malignant tumor in the neonate and infant

Answer 23

Wilms’ tumor (nephroblastoma)

Question 24

What is the most common type of obstruction of upper urinary tract?

Answer 24

Ureteropelvic Junction Obstruction (UPJ)

Question 25

What is the most common cause of a bladder outlet obstruction in a male neonate?

Answer 25

Posterior urethral valve obstruction

Question 26

What is the most common cause of renal cystic disease in neonate?

Answer 26

Multicystic dysplastic kidney (MDK) disease

Question 27

What has the “cluster of grapes” appearance?

Answer 27

Multicystic dysplastic kidney (MDK) disease

Question 28

What cystic kidney disease is most severe in neonatal and least severe in infantile to juvenile stage?

Answer 28

Prune Belly Syndrome

Question 29

What cystic kidney disease is typically seen during middle age?

Answer 29

Autosomal Dominant Polycystic Kidney (ADPKD)

Question 30

What renal abnormality has sudden fever, flank pain and tenderness?

Answer 30

Acute Pyelonephritis

Question 31

What is the most common renal tumor in a neonate?

Answer 31

Congenital Mesoblastic Nephroma (AKA fetal renal hamartoma or congenital Wilms’ tumor)

Question 32

What is the most common malignant renal tumor in young children and what is the typical age range?

Answer 32

Nephroblastoma (Wilms’ tumor)

o Incidence of tumor peaks between 2 and 5 years of age

Question 33

What malignant tumor arises from the sympathetic chain ganglia and adrenal medulla?

Answer 33

Neuroblastoma

Question 34

What can be caused by renal vein thrombosis?

Answer 34

Renal enlargement, Hematuria, proteinuria, low platelet count

Question 35

Where do you look when a patient has a Wilms’ Tumor for tumor invasion?

Answer 35

Renal vein, IVC, right atrium, and contralateral kidney

Question 36

What are some of the most common causes of hydronephrosis?

Answer 36

• Obstruction
• Reflux
• Abnormal muscle development