Chapter 7 The Urinary Tract Flashcards
What is the most common location for a urolithiasis to become lodged?
Ureterovesicular junction
a stone that completely fills the renal pelvis is referred to as:
Staghorn calculus
Clinical findings of Glomerulonephritis
- recent throat infection
- smoky urine
- hematuria
- proteinuria
- fever
- Hypertension
- Azotemia
The most common cause of fungal UTI is:
Candida Albicans
The presence of purulent material within the renal collecting system is termed:
Pyonephrosis
_____would be a common finding in a patient undergoing peritoneal dialysis?
Ascites
Suspicion of cortical thinning should occur when the renal cortex measures:
Less than 1cm
Clinical findings of a simple renal cyst
- Asymptomatic
The systemic disorder associated with epilepsy that leads to the development of solid tumors in various organs, including angiomyolipomas of the kidney, is:
Tuberous sclerosis
Describe the sonographic appearance of a kidney affected by ARPKD:
Bilateral enlarged, echogenic kidneys
Infantile polycystic kidney disease may also be referred to as:
ARPKD
_____would most likely present with a clinical finding of hematuria?
Hemorragic renal cyst
______ is considered the most common solid renal mass?
Angiomyolipoma
What is the most likely location of TCC in the kidney?
Renal pelvis
The inherited disorder associated with the development of tumors of the central nervous system and orbits, renal cysts, and adrenal tumors is:
Von Hippel-Lindau syndrome
Renal cysts that project out away from the kidney are termed:
Exophytic
Sonographically, compared to normal kidneys, those affected by CRF will appear:
Smaller in size and more echogenic
What renal cystic disease would be most likely caused by and thus associated with hemodialysis?
Acquired renal cystic disease
______is the most common cause of CRF
Diabetes mellitus
What is the most common location of an ectopic kidney:
Pelvis
A renal scar most likely appears as:
Echogenic area that extends from the renal sinus through the renal parenchyma
The most common congenital anomaly of the urinary tract is:
Duplicated collecting system
A bulge on the lateral border of the kidney is referred to as:
Dromedary hump
Enlargement of the unaffected contralateral kidney with unilateral renal agenesis or compromised renal function is AKA:
Compensatory hypertrophy
The vessel located anterior to the abdominal aorta and posterior to the superior mesenteric artery is the:
Left renal vein
The protective capsule of the kidney is referred to as:
Renal capsule
_____are retroperitoneal organs
Kidneys
What is the functional unit of the kidneys?
Nephron
_______is a childhood, autoimmune disease that results in the development of purple spots on the skin and possible renal failure?
Henoch-schonlein purpura
Sonographic findings of a renal hematoma
- Variable appearance depending on the stage of the blood
- Blood may accumulate under the capsule(subcapsular), in the perinephric area or intramuscular
- Chronic hematomas may calcify and produce acoustic shadowing
Clinical findings of a renal hematoma (5):
- trauma to the kidneys
- flank pain
- abdominal pain
- hematuria
- decreased hematocrit
_____is a primary form of renal cancer, meaning this form of cancer begins in the kidneys, specifically originates from renal tubular epithelium
Renal cell carcinoma
Clinical findings of renal cell carcinoma (7):
- Anorexia
- flank pain
- gross hematuria
- hypertension
- palpable mass
- smoker
- weight loss
Sonographic findings of renal cell carcinoma
- Hypoechoic, isoechoic or hyperechoic solid mass on the kidney
- Can have a complex cystic appearance as well
- check the renal vein and IVC for tumor invasion
______of the kidney is a malignant tumor that is most often found in the area of the renal pelvis
Transitional cell carcinoma
Clinical findings of renal transitional cell carcinoma
- gross hematuria
- pain secondary to renal obstruction
- history of smoking
Sonographic findings of renal transitional cell carcinoma (2):
- hypoechoic or isoechoic mass in renal sinus
- Hydronephrosis may be present
Renal adenoma typically measure:
Less than 1cm
_____is a benign mass that appears sonographically similar to its malignant counterpart, the RCC
Renal adenoma
Sonographic findings of renal adenoma
- Hyperechoic, vascular mass with internal calcifications
- May produce acoustic shadowing
Clinical findings of renal adenoma
- Asymptomatic
- May complain of hematuria
Sonographic findings of other renal malignancies
- Bilateral, hypoechoic masses with lymphoma
- Lymphoma or leukemia can manifest as an enlarged kidney
- Metastases have varying sono findings but most often solid tumors are hypoechoic or hyperechoic
Clinical findings of other renal malignancies
- History of primary cancer (often lung or breast)
- Hematuria
- fever
- weight loss
Compression or entrapment of the left renal vein as it passes between the SMA and abdominal aorta is termed:
Nutcracker syndrome
Clinical findings in nutcracker syndrome (4):
- Hematuria
- Proteinuria
- Possible left-sided abdominal or flank pain
- Left-sided testicular pain
Sonographic findings of nutcracker syndrome (2):
- Compression of the left renal vein
- Elevated pressure within the left renal vein
Sonographic findings of renal vein thrombosis
- heterogeneous renal echotexture
- enlarged renal vein
- absent renal vein doppler signals
- thrombus may not be seen
Clinical findings of renal artery stenosis
- Smoker
- high BP
- high cholesterol
- diabetes
- Hypertension that does not respond to treatment
____is a blood clot within the renal vein
Renal vein thrombosis
Clinical findings of renal vein thrombosis
- pain
- hematuria
Sonographically renal lipomas are:
- Well-circumscribed, hyperechoic mass
- Measures less than 5mm in diameter
Clinical findings of a renal lipoma
- Asymptomatic
Clinical findings of a renal hemangioma
- Asymptomatic
- Hemorrhage of the mass can lead to pain and hematuria
Sonographic findings of a renal hemangioma
- Small, hyperechoic mass
_____ is a benign renal tumor that is often found in men in their 60s and is the second most common renal mass after the angiomyolipoma
Oncocytoma
Sonographic findings of an oncocytoma
- Isoechoic, hyperechoic, or hypoechoic mass
- May also contain a hypoechoic central scar
Clinical findings of an oncocytoma
- Asymptomatic
- May produce pain or hematuria
______is the most common benign renal tumor
Angiomyolipoma
Clinical findings of angiomyolipoma (3):
- Asymptomatic in most individuals
- Patient may have a history of tuberous sclerosis
- Pain, hematuria and hypertension can occur with hemorrhage of the mass
Sonographic findings of angiomyolipoma (3):
- Solid, hyperechoic mass
- acoustic shadowing
- multiple and bilateral with tuberous sclerosis
Sonographically, cortical nephrocalcinosis appears as:
Small calculi within the cortex
Medullary sponge kidney appears sonographically as:
Highly echogenic renal pyramids that may shadow
Nephrocalcinosis that occurs within the cortex is termed:
Cortical nephrocalcinosis
Two forms of nephrocalcinosis
- Medullary nephrocalcinosis
- Cortical Nephrocalcinosis
______is the accumulation of calcium within abnormally dilated collecting ducts located within the medulla
Medullary sponge kidney
_____is an accumulation of calcium within the renal parenchyma
Nephrocalcinosis
Sonographic findings of nephrocalcinosis
- Medullary nephrocalcinosis (echogenic renal pyramids, medullary sponge kidney)
- Cortical nephrocalcinosis (echogenic foci within the cortex)
Clinical findings of nephrocalcinosis
- hypercalcemia
- hyperparathyroidism
- UTI
- history of urinary calculi
Sonographic findings of urolithiasis
- echogenic focus that produces acoustic shadowing
- “twinkle sign” seen posterior to the stone with the use of color doppler
- Hydronephrosis and dilation or ureter may be present
A stone that completely fills and takes on the shape of the renal pelvis is called
Staghorn calculus
_____are kidney stones located anywhere within the urinary tract
urolithiasis
Clinical findings of urolithiasis (4):
- hematuria
- renal colic
- oliguria
- UTI
Abnormalities that are located outside the urinary tract that leads to renal obstruction are referred to as:
Extrinsic causes of hydronephrosis
Irregularities that lead to renal obstruction that are located inside the urinary tract are called:
intrinsic causes of hydronephrosis
____is dilation of the calices, infundibula and renal pelvis
Hydronephrosis
sonographic findings of renal artery stenosis
- thickening and calcification of the renal artery may not be noted
- renal to aorta ratio that is greater than 3.5
- possibly a tardus-parvus spectral waveform downstream from the stenosis
Sonographic findings of hydronephrosis
- anechoic fluid filling all or part of the renal collecting system
- can also alter the renal artery resistive index within the arcuate or interlobar vessels
Dilation of the urinary tract occurs:
proximal to the level of obstruction
Sonographic findings of chronic glomerulonephritis
- Small, echogenic kidneys
Clinical findings of renal fungal disease
- immunocompromised person
- diabetes mellitus intravenous drug abuse or long-standing indwelling catheter
- infant with an indwelling catheter
- flank pain
- fever
- chills
Clinical findings of glomerulonephritis (7):
- recent throat infection (acute)
- smoky urine
- hematuria
- proteinuria
- fever
- hypertension
- Azotemia