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OB-Hagen > Chapter 64 Fetal Urogenital system > Flashcards

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

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2
Q

first pair of kidneys that are rudimentary and nonfunctional–

A

pronephros

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3
Q

second pair of kidneys that function for a short time during early fetal period. Degenerate after being replaced by metanephros

A

mesonephros

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4
Q

urine formation begins toward the end of the ____

A

1st trimester

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5
Q

kidneys do not need to function as waste filtration because:

A

placenta eliminates waste from fetal blood

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6
Q

___% of adult kidneys have 2-4 renal arteries

A

25%

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7
Q

the kidneys initially lie:

A

close together in the pelvis

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8
Q

normal kidney migration is complete by:

A

9th week

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9
Q

external genitalia are fully differentiated by:

A

12 weeks

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10
Q

kidneys are evaluated on:

A

anatomy
texture
size

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11
Q

by 12 weeks ___% of kidneys may be imaged

A

86%

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12
Q

kidneys may be seen as early as ___ weeks with TVS

A

9 weeks

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13
Q

fetal kidneys and bladder are seen by ___

A

13 weeks

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14
Q

overall echogenicity of kidneys decrease at about:

A

15 weeks

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15
Q

you are able to distinguish renal cortex from medulla by:

A

25 weeks

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16
Q

the ____ of the kidney closely correlates with gestational age

A

length

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17
Q

round anechoic structure centrally located in the pelvis:

A

bladder

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18
Q

bladder usually takes at least ____ to fill and empty

A

30 minutes

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19
Q

duplication of the renal collecting system is common and usually happens in

A

females

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20
Q

if kidneys are not seen sonographically, look in the

A

pelvis

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21
Q

kidney should be seen at the same level as the

A

spine

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22
Q

not visualizing the bladder indicates:

A

a severe renal anomaly, especially when accompanied with oligohydramnios

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23
Q

dilated ureters

A

hydroureters

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24
Q

hydroureters are visualized as

A

tortuous cystic masses

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25
Q

renal malformations are divided into 2 categories:

A
  1. congenital

2. obstructive

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26
Q

absence of 1 or both kidneys

A

renal agenesis

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27
Q

occurs when ureteric buds fail to develop or they degenerate

A

renal agenesis

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28
Q

these two things have been found to be related to renal agenesis:

A
  • cocaine use

- diabetes

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29
Q

one functioning kidney

A

unilateral renal agenesis

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30
Q

unilateral renal agenesis prognosis

A

excellent survival rates

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31
Q

sonographic appearance of unilateral renal agenesis

A

remaining kidney will be enlarged(complensatory hypertrophy)

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32
Q

unilateral renal agenesis; the bladder is:

A

visualized, normal

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33
Q

bilateral renal agenesis is referred as

A

Potter’s syndrome

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34
Q

bilateral renal agenesis is lethat due to:

A
  • renal insufficiency

- pulmonary hypoplasia

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35
Q

potter’s syndrome is characterized by what findings?

A
  • oligohydramnios
  • renal failur/bilateral renal agenesis
  • abnormally positioned extremeties
  • flat nose
  • recessed chin
  • abnormal ears
  • wide-set eyes
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36
Q

sonographic findings of bilateral renal agenesis

A
  • adrenal gland may mimic absent kidney
  • severe oligohydramnios
  • absent bladder
  • absent kidneys or renal arteries
  • small thorax
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37
Q

horseshoe kidney forms when ____ poles of kidney fuse while they’re in the pelvis

A

inferior

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38
Q

horseshoe kidney is more common in _____

A

2-3 times more common in males

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39
Q

occurs when kidney lies outside of its normal position

A

renal ectopia

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40
Q

associated anomalies with renal ectopia:

A
  • skeletal
  • cardiovascular
  • gynecologic
  • GI
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41
Q

abnormally located kidney appears:

A
  • small
  • rotated/oblique
  • typically lies superior to bladder(if found in pelvis)
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42
Q

this causes urine to drain from the bladder to the umbilicus:

A

urachal fistula

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43
Q

if only a small part of the bladder lumen persists while the urachus forms, a _____ forms

A

urachal cyst

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44
Q

if a large part of the bladder lumen persists while the urachus forms, a _____ forms

A

patent urachus

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45
Q

used to describe renal diseases other than renal agenesis that result in renal failure and facial/structural abnormalities caused by oligohydramnios

A

potters sequence/classification

46
Q

IPKD/ARPKD leads to overall ____ of kidneys

A

enlargement

47
Q

sonographic appearance of IPKD/ARPKD

A
  • englarged, hyperechoic kidneys
  • small/absent bladder
  • oligohydramnios
  • renal failure
48
Q

IPKD/ARPKD may occur with:

A
  • Meckel-gruber syndrome

- trisomy 13

49
Q

multiple, smooth-walled, nonfunctioning, noncommunicating cysts on the kidney(s)

A

MCDK

50
Q

most common form of renal cystic disease in childhood

A

MCDK

51
Q

MCDK is linked to:

A

maternal diabetes

52
Q

MCDK more often occurs in ____

A

males

53
Q

most cases of MCDK are __-lateral

A

unilateral

54
Q

the bladder with MCDK appears:

A

normal

55
Q

MCDK is thought to occur from:

A
  • early obstruction

- abnormal development of metanephric mesoderm & ureteric bud

56
Q

bilateral MCDK prognosis is _____

A

lethal

57
Q

sonographic appearance of bilateral MCDK

A
  • oligohydramnios

- absent bladder

58
Q

unilateral MCDK, the contralateral kidney will be

A

enlarged

59
Q

most common hereditary renal cystic disease

A

ADPKD

60
Q

sonographic appearance of ADPKD

A
  • kidneys are symmetrically enlarged and echogenic, or normal
  • normal AFI
  • almost always bilateral
  • bladder present
61
Q

if obstruction occurs early:

A

multicystic kidney may develop

62
Q

if obstruction occurs 1st or 2nd trimester:

A

cystic dysplasia may result

63
Q

if obstruction occurs late:

A

produces hydronephrosis

64
Q

dilation of the renal pelvis and calyces

A

pelviectasis

65
Q

dilation of the renal pelvis without dilation of the calyces

A

pylectasis

66
Q

pelviectasis will occur in:

A

hydronephrosis

67
Q

most common fetal anomaly

A

hydronephrosis

68
Q

unilateral hydronephrosis usually occurs from obstruction at the ____

A

UPJ

69
Q

dilation of the renal pelvis due to blockage of urine at some junction in the urinary system

A

hydronephrosis

70
Q

you find an abnormal intrapelvic AP diameter measurement, this is suggestive of:

A

hydronephrosis

71
Q

mild pylectasis is associated with ______

A

down syndrome

72
Q

most common reason for hydronephrosis in the neonate

A

UPJ obstruction

73
Q

UPJ & UVJ is more common in

A

males

74
Q

UPJ sonographically, collection of anechoic urine located medially within the renal pelvis communicating with the calyces, may appear ____ shaped

A

bullet

75
Q

UVJ obstruction leads to :

A

megaureter

76
Q

majority of the causes for megaureter is due to

A

distal portion of ureter being aperistalic

77
Q

posterior urethral valve obstruction results in

A
  • hydronephrosis

- dilation of bladder and posterior urethra

78
Q

most common urethral anomaly

A

posterior urethral valve obstruction (PUV)

79
Q

most common cause of infravesical obstruction in males

A

posterior urethral valve obstruction

80
Q

severely thickened bladder wall with dilated posterior urethra is referred to as the _____ sign

A

key-hole sign

81
Q

key-hole sign occurs with

A

Posterior Urethral Valve obstruction (PUV)

82
Q

congenital defect resulting in obstruction of the anterior urethral valves, occurs in males

A

anterior urethral valve obstruction

83
Q

Prune belly syndrome is also referred as:

A

Eagle-Barret syndrome

84
Q

characterized by 3 things:

  1. cryptorchidism
  2. agenesis/hypoplasia of abdominal wall muscles
  3. dilation of collecting system
A

prune belly syndrome

85
Q

prune belly syndrome is seen mostly in

A

males

86
Q

prune belly syndrome may lead to

A

renal dysplasia and pulmonary hypoplasia

87
Q

cystic dilation of the bladder segment of the distal ureter

A

ureterocele

88
Q

Ureterocele is more common in _____ if system is duplicated

A

females

89
Q

Ureterocele is more common in _____ if system is normal/not duplicated

A

males

90
Q

most common renal tumor

A

mesoblastic nephroma

91
Q

mesoblastic nephroma is referred to as

A

hamartoma

92
Q

malignant tumor of the adrenal gland

A

neuroblastoma

93
Q

neuroblastoma usually presents in the ___ trimester

A

3rd trimester

94
Q

Neuroblastoma is likely to metastasize to the liver in utero if:

A

the mass is solid

95
Q

accumulation of fluid around the testicle(s)

A

hydrocele

96
Q

hydroceles have been reported with

A

hydrops

97
Q

testes remain near deep inguinal rings until ____ weeks

A

28 weeks

98
Q

cryptorchidism is associated with risk of:

A
  • torsion

- cancer

99
Q

abnormal opening of the urethra, birth defect in boys

A

hypospadias

100
Q

ambiguous genitalia typically result from:

A

chromosomal defects or abnormal hormone levels

101
Q

inability to delineate fetal gender

A

ambiguous genitalia

102
Q

rare, have both ovaries and testes

A

true hermaphroditism

103
Q

most fetuses with true hermaphroditism will have ____ karyotype

A

normal, some are mosaics

104
Q

female pseudohermaphrodites has a ___ karyotype

A

46, XX

105
Q

most common cause of female pseudohermaphrodites is

A

congenital virializing adrenal hyperplasia

106
Q

congenital virializing adrenal hyperplasia causes

A

masculinization of external genitalia

107
Q

male pseudohermaphrodites has a ____ karyotype

A

46, XY

108
Q

chromosomal anomalies associated with ambiguous genitalia:

A
  • trisomy 13
  • triploidy
  • certain deletions
  • translocation
109
Q

most common cystic mass in female fetus

A

fetal ovaria cyst

110
Q

obstruction of uterus and vagina

A

hydrometrocolpos

111
Q

hydrometrocolpos results from

A
  • imperforate hymen

- atresia of vagina/cervix

OB-Hagen (17 decks)

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