Chapter 64 Fetal Urogenital system Flashcards
1
Q
of the 3 sets of ecretory organs that develop in the embryo, which one remains as permanent kidneys?
A
metanephros
2
Q
first pair of kidneys that are rudimentary and nonfunctional–
A
pronephros
3
Q
second pair of kidneys that function for a short time during early fetal period. Degenerate after being replaced by metanephros
A
mesonephros
4
Q
urine formation begins toward the end of the ____
A
1st trimester
5
Q
kidneys do not need to function as waste filtration because:
A
placenta eliminates waste from fetal blood
6
Q
___% of adult kidneys have 2-4 renal arteries
A
25%
7
Q
the kidneys initially lie:
A
close together in the pelvis
8
Q
normal kidney migration is complete by:
A
9th week
9
Q
external genitalia are fully differentiated by:
A
12 weeks
10
Q
kidneys are evaluated on:
A
anatomy
texture
size
11
Q
by 12 weeks ___% of kidneys may be imaged
A
86%
12
Q
kidneys may be seen as early as ___ weeks with TVS
A
9 weeks
13
Q
fetal kidneys and bladder are seen by ___
A
13 weeks
14
Q
overall echogenicity of kidneys decrease at about:
A
15 weeks
15
Q
you are able to distinguish renal cortex from medulla by:
A
25 weeks
16
Q
the ____ of the kidney closely correlates with gestational age
A
length
17
Q
round anechoic structure centrally located in the pelvis:
A
bladder
18
Q
bladder usually takes at least ____ to fill and empty
A
30 minutes
19
Q
duplication of the renal collecting system is common and usually happens in
A
females
20
Q
if kidneys are not seen sonographically, look in the
A
pelvis
21
Q
kidney should be seen at the same level as the
A
spine
22
Q
not visualizing the bladder indicates:
A
a severe renal anomaly, especially when accompanied with oligohydramnios
23
Q
dilated ureters
A
hydroureters
24
Q
hydroureters are visualized as
A
tortuous cystic masses
25
renal malformations are divided into 2 categories:
1. congenital
| 2. obstructive
26
absence of 1 or both kidneys
renal agenesis
27
occurs when ureteric buds fail to develop or they degenerate
renal agenesis
28
these two things have been found to be related to renal agenesis:
- cocaine use
| - diabetes
29
one functioning kidney
unilateral renal agenesis
30
unilateral renal agenesis prognosis
excellent survival rates
31
sonographic appearance of unilateral renal agenesis
remaining kidney will be enlarged(complensatory hypertrophy)
32
unilateral renal agenesis; the bladder is:
visualized, normal
33
bilateral renal agenesis is referred as
Potter's syndrome
34
bilateral renal agenesis is lethat due to:
- renal insufficiency
| - pulmonary hypoplasia
35
potter's syndrome is characterized by what findings?
- oligohydramnios
- renal failur/bilateral renal agenesis
- abnormally positioned extremeties
- flat nose
- recessed chin
- abnormal ears
- wide-set eyes
36
sonographic findings of bilateral renal agenesis
- adrenal gland may mimic absent kidney
- severe oligohydramnios
- absent bladder
- absent kidneys or renal arteries
- small thorax
37
horseshoe kidney forms when ____ poles of kidney fuse while they're in the pelvis
inferior
38
horseshoe kidney is more common in _____
2-3 times more common in males
39
occurs when kidney lies outside of its normal position
renal ectopia
40
associated anomalies with renal ectopia:
- skeletal
- cardiovascular
- gynecologic
- GI
41
abnormally located kidney appears:
- small
- rotated/oblique
- typically lies superior to bladder(if found in pelvis)
42
this causes urine to drain from the bladder to the umbilicus:
urachal fistula
43
if only a small part of the bladder lumen persists while the urachus forms, a _____ forms
urachal cyst
44
if a large part of the bladder lumen persists while the urachus forms, a _____ forms
patent urachus
45
used to describe renal diseases other than renal agenesis that result in renal failure and facial/structural abnormalities caused by oligohydramnios
potters sequence/classification
46
IPKD/ARPKD leads to overall ____ of kidneys
enlargement
47
sonographic appearance of IPKD/ARPKD
- englarged, hyperechoic kidneys
- small/absent bladder
- oligohydramnios
- renal failure
48
IPKD/ARPKD may occur with:
- Meckel-gruber syndrome
| - trisomy 13
49
multiple, smooth-walled, nonfunctioning, noncommunicating cysts on the kidney(s)
MCDK
50
most common form of renal cystic disease in childhood
MCDK
51
MCDK is linked to:
maternal diabetes
52
MCDK more often occurs in ____
males
53
most cases of MCDK are __-lateral
unilateral
54
the bladder with MCDK appears:
normal
55
MCDK is thought to occur from:
- early obstruction
| - abnormal development of metanephric mesoderm & ureteric bud
56
bilateral MCDK prognosis is _____
lethal
57
sonographic appearance of bilateral MCDK
- oligohydramnios
| - absent bladder
58
unilateral MCDK, the contralateral kidney will be
enlarged
59
most common hereditary renal cystic disease
ADPKD
60
sonographic appearance of ADPKD
- kidneys are symmetrically enlarged and echogenic, or normal
- normal AFI
- almost always bilateral
- bladder present
61
if obstruction occurs early:
multicystic kidney may develop
62
if obstruction occurs 1st or 2nd trimester:
cystic dysplasia may result
63
if obstruction occurs late:
produces hydronephrosis
64
dilation of the renal pelvis and calyces
pelviectasis
65
dilation of the renal pelvis without dilation of the calyces
pylectasis
66
pelviectasis will occur in:
hydronephrosis
67
most common fetal anomaly
hydronephrosis
68
unilateral hydronephrosis usually occurs from obstruction at the ____
UPJ
69
dilation of the renal pelvis due to blockage of urine at some junction in the urinary system
hydronephrosis
70
you find an abnormal intrapelvic AP diameter measurement, this is suggestive of:
hydronephrosis
71
mild pylectasis is associated with ______
down syndrome
72
most common reason for hydronephrosis in the neonate
UPJ obstruction
73
UPJ & UVJ is more common in
males
74
UPJ sonographically, collection of anechoic urine located medially within the renal pelvis communicating with the calyces, may appear ____ shaped
bullet
75
UVJ obstruction leads to :
megaureter
76
majority of the causes for megaureter is due to
distal portion of ureter being aperistalic
77
posterior urethral valve obstruction results in
- hydronephrosis
| - dilation of bladder and posterior urethra
78
most common urethral anomaly
posterior urethral valve obstruction (PUV)
79
most common cause of infravesical obstruction in males
posterior urethral valve obstruction
80
severely thickened bladder wall with dilated posterior urethra is referred to as the _____ sign
key-hole sign
81
key-hole sign occurs with
Posterior Urethral Valve obstruction (PUV)
82
congenital defect resulting in obstruction of the anterior urethral valves, occurs in males
anterior urethral valve obstruction
83
Prune belly syndrome is also referred as:
Eagle-Barret syndrome
84
characterized by 3 things:
1. cryptorchidism
2. agenesis/hypoplasia of abdominal wall muscles
3. dilation of collecting system
prune belly syndrome
85
prune belly syndrome is seen mostly in
males
86
prune belly syndrome may lead to
renal dysplasia and pulmonary hypoplasia
87
cystic dilation of the bladder segment of the distal ureter
ureterocele
88
Ureterocele is more common in _____ if system is duplicated
females
89
Ureterocele is more common in _____ if system is normal/not duplicated
males
90
most common renal tumor
mesoblastic nephroma
91
mesoblastic nephroma is referred to as
hamartoma
92
malignant tumor of the adrenal gland
neuroblastoma
93
neuroblastoma usually presents in the ___ trimester
3rd trimester
94
Neuroblastoma is likely to metastasize to the liver in utero if:
the mass is solid
95
accumulation of fluid around the testicle(s)
hydrocele
96
hydroceles have been reported with
hydrops
97
testes remain near deep inguinal rings until ____ weeks
28 weeks
98
cryptorchidism is associated with risk of:
- torsion
| - cancer
99
abnormal opening of the urethra, birth defect in boys
hypospadias
100
ambiguous genitalia typically result from:
chromosomal defects or abnormal hormone levels
101
inability to delineate fetal gender
ambiguous genitalia
102
rare, have both ovaries and testes
true hermaphroditism
103
most fetuses with true hermaphroditism will have ____ karyotype
normal, some are mosaics
104
female pseudohermaphrodites has a ___ karyotype
46, XX
105
most common cause of female pseudohermaphrodites is
congenital virializing adrenal hyperplasia
106
congenital virializing adrenal hyperplasia causes
masculinization of external genitalia
107
male pseudohermaphrodites has a ____ karyotype
46, XY
108
chromosomal anomalies associated with ambiguous genitalia:
- trisomy 13
- triploidy
- certain deletions
- translocation
109
most common cystic mass in female fetus
fetal ovaria cyst
110
obstruction of uterus and vagina
hydrometrocolpos
111
hydrometrocolpos results from
- imperforate hymen
| - atresia of vagina/cervix
