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ABDOMEN REGISTRY > Chapter 4. Urinary Tract > Flashcards

Chapter 4. Urinary Tract Flashcards

1
Q

What is the normal renal cortex measurement?

A

The normal renal cortex measures > 1 CM

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2
Q

The fibrous sheath enclosing the kidneys and adrenal glands is known as the Gerota’s fascia. What is another term for this sheath?

A

Perirenal space

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3
Q

Describe the blood flow of the kidneys starting with the main renal artery.

A

Main renal artery
five segmental arteries
interlobar arteries
arcuate arteries
interlobular arteries

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4
Q

What is the most common fusion anomaly of the kidneys?

A

Horseshoe kidneys are the most common fusion anomaly of the kidneys

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5
Q

Kidneys may fuse to form a round mass in the pelvis, this is known as…

A

Discoid or pancake kidney

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6
Q

A common variant of cortical thickening on the lateral aspect of the left kidney is known as…

A

Dromedary hump

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7
Q

A normal variation of prominent renal cortical parenchyma located between two medullary pyramids.

A

Column of bertin (septal cortex)

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8
Q

A triangular hyperechoic area on the anterior aspect of the upper pole of the right kidney is known as…

A

Junctional parenchymal defect aka Fetal lobulation

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9
Q

What complication may occur in the upper pole of a complete duplex collecting system due to the ectopic location of the ureter entering the bladder?

A

With complete double collecting system, the ureter draining the upper pole typically inserts in an ectopic location on the bladder. This can cause the formation of a ureterocele. The ureterocele will cause hydroureter and hydronephrosis of the upper collecting system of the kidney.

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10
Q

Unilateral renal agenesis could be solitary or could be associated with VACTERL and or MURCS. What do these acronyms stand for?

A

V- vertebral defects M- Mullerian agenesis
A- anal atresia U-
C- cardiovascular anomalies R- renal agenesis
TE- Tracheoesophageal fistula C-cervicothoracic
R- renal anomalies S- somite abnormalities
L- limb defects

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11
Q

A cystic collection medial to the renal hilum may be a…

A

Extrarenal pelvis

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12
Q

What is the most common cause of urinary obstruction in the male neonatal patient?

A

Posterior urethral valve

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13
Q

What is the sonographic hallmark sign of posterior urethral valve?

A

Key-hole appearance

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14
Q

Defines imaging characteristics that relate to increased chances of malignancy, a criteria

A

Bosniak renal cyst classification

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15
Q

Bilateral renal enlargement due to the development of numerous cysts of varying sizes. Associated with liver, pancreatic and splenic cysts as well as arterial aneurysms (specifically cerebral arterial (Berry) aneurysms of the circle of Willis.

A

Autosomal dominant polycystic kidney disease

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16
Q

Enlarged, bilaterally hyperechoic parenchyma with loss of the medullary distinction. Associated with pulmonary hypoplasia, hepatic fibrosis and portal hypertension. Typically detected in utero.

A

Autosomal recessive polycystic kidney disease

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17
Q

Refers to the typical physical appearance of a neonate as a direct result of oligohydramnios and compression while in utero

A

Potters syndrome

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18
Q

What are some causes of Potters syndrome?

A

Bilateral renal agenesis
Autosomal recessive polycystic kidney disease
Autosomal dominant polycystic kidney disease
Multicystic renal dysplasia
Obstructive uropathy (posterior urethral valve)
PROM

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19
Q

What is the most common cause of an abdominal mass in NEWBORNS

A

Multicystic dysplastic kidneys

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20
Q

Describe what multicystic dysplastic kidneys are and what causes them…

A

A form of renal dysplasia characterized by multiple NONcommunicating cysts with the absence of renal parenchyma. It is the result of atresia of the ureteropelvic junction during fetal development.

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21
Q

What is the most common cause of hydronephrosis in the male fetus ?

A

Ureteropelvic junction obstruction

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22
Q

What kidney condition results in hyperechoic medullary pyramids due to calcium deposits?

A

Medullary sponge kidney

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23
Q

What kind of patients develop acquired cystic disease? What disease are pts with acquired cystic disease at a higher risk of?

A

Patients on long-term hemodialysis develop acquired cystic disease. Patients with acquired cystic disease are at an increased risk of renal cell carcinoma.

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24
Q

Von-Hippel-Lindau disease is an inherited disease that usually presets in the 2nd to 3rd decade of life with serious visual impairment. What are the four major tumors that are related to Von-Hippel-Lindau disease?

A

Renal cell carcinoma
Islet cell tumors
Pheochromocytomas
Renal and pancreatic cysts

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25
Q

Benign hyperechoic renal tumor, 80% occurring in the right kidney, may have propagation speed artifact…

A

Angiomyolipoma

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26
Q

Patients with tuberous sclerosis have a high incidence of what renal lesions?

A

Patients with tuberous sclerosis have a high incidence of renal cysts and angiomyolipomas

27
Q

What is the most common solid renal mass in the adult?

A

Renal cell carcinoma

28
Q

What is the most common patient symptom associated with renal cell carcinoma?

A

Hematuria

29
Q

Renal cell carcinoma most commonly metastasizes to the…

A

Lungs

30
Q

A benign renal tumor that has a CT and MRI appearance of a central scar or a spoke wheel pattern on angiograms is known as…

A

Renal oncocytoma

31
Q

What is the most common childhood renal tumor occurring mostly at 3.5 years of age?

A

Wilms tumor aka Nephroblastoma

32
Q

How will a patient with nephroblastoma present…

A

Approx 3.5 years of age
a large asymptomatic flank mass
may have HTN, fever or hematuria

33
Q

Nephroblastoma is associated with which syndrome?

A

Beckwith -weidemann syndrome

34
Q

What is the most common renal tumor in neonates and infants?

A

Mesoblastic nephroma is the most common renal tumor in neonates and infants

35
Q

Acute pyelonephritis is typically diagnosed clinically. List the sonographic signs that may present with pyelonephritis

A

Renal enlargement, hypoechoic parenchyma, absence of sinus echoes.

NOTE - when an infection is focal, it is called acute focal bacterial nephritis or lobar nephronia. US appearance will be a focal wedge-shaped area or a hypoechoic renal lobe

36
Q

What is the treatment for emphysematous pyelonephritis?

A

Nephrectomy

37
Q

What is the hallmark sign of xanthogranulomatous pyelonephritis?

A

Staghorn calculus

38
Q

Purulent material in the collecting system of the kidney is referred to as…

A

Pyonephrosis

39
Q

What is the most common cause of fungal infections worldwide?

A

Candida

40
Q

A kidney fungal ball is aka…

A

Mycetoma

41
Q

What is the most common cause of acute kidney injury (failure)?

A

Acute tubular necrosis is the most common cause of acute kidney injury (failure)

42
Q

Acute tubular necrosis most likely occurs in patients with hx of…

A

recent surgery, sepsis or hypovolemia

43
Q

What is the most common area of obstruction by a stone in ADULTS?

A

Ureterovesical junction is the most common area of obstruction in adults

44
Q

Patients with congenital malformations of the kidneys and or urinary tract are associated with…

A

Outer ear abnormalities and a single umbilical artery

45
Q

List the values for normal, mild, moderate, and severe hydronephrosis in pediatrics…

A

Normal <7 mm
Mild 7-8 mm
Moderate 9-15 mm
Severe >15 mm

46
Q

— is the most common cause of pediatric hydronephrosis, occurs more commonly in males and on the left kidney

A

Ureteropelvic obstruction (UPJ)

47
Q

A megaureter is defined as a dilated ureter measuring…

A

> 7 mm in diameter

48
Q

What is the most common cause of nephrocalcinosis in ADULTS

A

Primary hyperparathyroisism

49
Q

A condition in which there is calcium deposition in the renal pyramids

A

Anderson-carr-randall

50
Q

A condition in which calcium levels in the kidneys are elevated is called

A

Nephrocalcinosis

51
Q

What condition of the kidneys can be identified by sloughed papilla in the urine and triangular cystic collections representing the absence of medullary pyramids

A

Papillary necrosis

52
Q

What condition of the kidneys can be identified by sloughed papilla in the urine and triangular cystic collections representing the absence of medullary pyramids

A

Papillary necrosis

53
Q

Increased renal sinus fat that replaces normal parenchyma, associated with obesity, atherosclerosis and steroids

A

Renal sinus lipomatosis

54
Q

The apex of the bladder is connected to the umbilicus by the…

A

Median umbilical ligament or urachus

55
Q

What is the normal bladder wall thickness for distended and non distended?

A

Distended < 3 mm
Nondistended <5 mm

56
Q

The bladder volume formula is…

A

L x W x H x 0.56

57
Q

Ureteroceles are most commonly found in association with…

A

complete uretral duplication

58
Q

What is the most common bladder neoplasm?

A

Transitional cell carcinoma is the most common bladder neoplasm

59
Q

What is the most common clinical presentation of transitional cell carcinoma?

A

Hematuria

NOTE - a solid mass or bladder wall thickening should raise suspicion for transitional cell CA

60
Q

What is the normal renal RI? (resistive index)

A

Normal renal RI is typically <0.7

61
Q

What is the most common cause of renal disease leading to kidney transplantation?

A

Diabetes is the most common cause of renal disease leading to renal transplantation

62
Q

List the sonographic findings of acute renal transplant rejection

A

Renal enlargement
hypoechoic parenchyma
loss of the cortical medullary boundary
increased RI

63
Q

Which kidney is favored for harvesting?

A

The left kidney is favored for harvesting due to its longer renal vein

ABDOMEN REGISTRY (6 decks)

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