Chapter 27 - The Neonatal and Pediatric Kidneys and Adrenal Glands Flashcards
occurs when the fetus is stressed during a difficult delivery or a hypoxic insult (lack of oxygen)
adrenal hemorrhage
lie at the base of the medullary pyramids and appear as echogenic structures
arcuate arteries
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
autosomal dominant polycystic kidney disease (ADPKD)
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
autosomal recessive polycystic kidney disease (ARPKD)
most common benign renal tumor of the neonate and infant
congenital mesoblastic nephroma
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
cortex
dilatation of any tubular vessel
ectasia
occurs more commonly in females (on left side); ectopic insertion and cystic dilation of distal ureter of a duplicated renal collecting system
ectopic ureterocele
dilation of the renal collecting system
hydronephrosis
large and hypoechoic in the neonate
medullary pyramids
most common cause of renal cystic disease in the neonate; multiple cystic masses within the kidney; may have contralateral ureteral pelvic junction obstruction
multicystic dysplastic kidney (MCDK)
abnormal persistence of fetal renal blastema (potential to develop into Wilms’ tumor)
nephroblastomatosis
malignant adrenal mass seen in pediatric patients; hemorrhaging tumor principally consisting of cells resembling neuroblasts
neuroblastoma
poorly functioning enlarged kidneys
polycystic renal disease
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
posterior urethral valve
classification of cystic renal disease
Potter facies
dilation of the fetal abdomen secondary to severe bilateral hydronephrosis and fetal ascites; fetus also has oligohydramnios and pulmonary hypoplasia
prune belly syndrome
underdevelopment of the lung tissue that occurs in utero secondary to oligohydramnios
pulmonary hypoplasia
kidney becomes enlarged and edematous as a result of obstruction of the renal vein
renal vein thrombosis
most common neonatal obstruction of the urinary tract; results from intrinsic narrowing or extrinsic vascular compression
ureteropelvic junction obstruction
adds cardiac and limb anomalies to the VATER syndrome
VACTERL
vertebral, anal, tracheoesophageal fistula, and renal anomalies
VATER
most frequent malignant tumor in the neonate and infant
Wilms’ tumor (nephroblastoma)
What is the most common type of obstruction of upper urinary tract?
Ureteropelvic Junction Obstruction (UPJ)
What is the most common cause of a bladder outlet obstruction in a male neonate?
Posterior urethral valve obstruction
What is the most common cause of renal cystic disease in neonate?
Multicystic dysplastic kidney (MDK) disease
What has the “cluster of grapes” appearance?
Multicystic dysplastic kidney (MDK) disease
What cystic kidney disease is most severe in neonatal and least severe in infantile to juvenile stage?
Prune Belly Syndrome
What cystic kidney disease is typically seen during middle age?
Autosomal Dominant Polycystic Kidney (ADPKD)
What renal abnormality has sudden fever, flank pain and tenderness?
Acute Pyelonephritis
What is the most common renal tumor in a neonate?
Congenital Mesoblastic Nephroma (AKA fetal renal hamartoma or congenital Wilms’ tumor)
What is the most common malignant renal tumor in young children and what is the typical age range?
Nephroblastoma (Wilms’ tumor)
o Incidence of tumor peaks between 2 and 5 years of age
What malignant tumor arises from the sympathetic chain ganglia and adrenal medulla?
Neuroblastoma
What can be caused by renal vein thrombosis?
Renal enlargement, Hematuria, proteinuria, low platelet count
Where do you look when a patient has a Wilms’ Tumor for tumor invasion?
Renal vein, IVC, right atrium, and contralateral kidney
What are some of the most common causes of hydronephrosis?
- Obstruction
- Reflux
- Abnormal muscle development
