Chapter 7: The Urinary Tract Flashcards
1
Q
a cystic disease of the kidney that is often the result of chronic hemodialysis
A
acquired renal cystic disease
2
Q
an inflammation of the kidney or kidneys
A
acute pyelonephritis
3
Q
damage to the tubule cells within the kidneys that results in renal failure
A
acute tubular necrosis
4
Q
an excess of urea or other nitrogenous compounds in the blood
A
azotemia
5
Q
a measure of the amount of nitrogen in the blood in the form of urea
A
blood urea nitrogen (BUN)
6
Q
a chronic inflammation of the kidney or kidneys
A
chronic pyelonephritis
7
Q
an extension of the renal cortex located between the renal pyramids
A
columns of Bertin
8
Q
the dilation of the renal collecting system at birth
A
congenital hydronephrosis
9
Q
the accumulation of calcium within the cortex of the kidney
A
cortical nephrocalcinosis
10
Q
the muscle that controls the appropriate emptying of the urinary bladder
A
detrusor muscle
11
Q
the formation of air within the kidney parenchyma secondary to bacterial infiltration
A
emphysematous pyelonephritis
12
Q
the fibrous envelope of tissue that surrounds the kidney and adrenal gland
A
Gerota fascia
13
Q
the dilation of the renal collecting system resulting from the obstruction of the flow of urine from the kidney(s) to the bladder; also referred to as pelvocaliectasis
A
hydronephrosis
14
Q
abnormally high levels of potassium in the blood
A
hyperkalemia
15
Q
carcinoma of the kidney; also referred to as renal cell carcinoma
A
hypernephroma
16
Q
an inherited renal disease that results in bilateral enlargement of the fetal kidneys and microscopic renal cysts; also referred to as autosomal recessive polycystic kidney disease
A
infantile polycystic kidney disease
17
Q
an enzyme found within the blood that may be used to monitor renal function; may also be used as a tumor marker for some ovarian tumors
A
lactate dehydrogenase
18
Q
the accumulation of calcium within the medulla of the renal parenchyma
A
medullary nephrocalcinosis
19
Q
a congenital disorder characterized by the accumulation of calcium within the abnormally dilated collecting ducts located within the medulla
A
medullary sponge kidney
20
Q
a renal disease thought to be caused by an early renal obstruction; leads to the development of multiple noncommunicating cysts of various sizes in the renal fossa
A
multicystic dysplastic kidney disease
21
Q
the most common solid malignant pediatric abdominal mass; a malignant renal mass that may also be referred to as a Wilms tumor
A
nephroblastoma
22
Q
an accumulation of calcium within the renal parenchyma
A
nephrocalcinosis
23
Q
the functional unit of the kidney
A
nephron
24
Q
a kidney disorder caused by damage to the glomeruli, which results in excess amounts of protein in the urine and the swelling of the ankles, face, and feet due to accumulation of excess water
A
nephrotic syndrome
25
a bladder that is poorly functioning secondary to any type of neurological disorder
neurogenic bladder
26
a scant or decreased urine output
oliguria
27
a benign renal tumor that is often found in men in their 60s
oncocytoma
28
a benign, solid adrenal tumor associated with uncontrollable hypertension
pheochromocytoma
29
the condition of having pus within the collecting system of the kidney
pyonephrosis
30
pus within the urine
pyuria
31
a benign renal mass
renal cell adenoma
32
the carcinoma of the kidney; also referred to as hypernephroma
renal cell carcinoma
33
a sharp pain in the lower back that radiates into the groin and is typically associated with the passage of a urinary stone through the ureter
renal colic
34
the outer part of the renal parenchyma that is responsible for filtration
renal cortex
35
a benign renal mass that consists of blood vessels
renal hemangioma
36
a collection of blood on or around the kidney typically associated with some form of trauma
renal hematoma
37
a fatty tumor on the kidney
renal lipoma
38
the inner part of the renal parenchyma that is responsible for absorption
renal medulla
39
cone-shaped structures located within the renal medulla that contains part of the nephron
renal pyramids
40
the portion of the kidney containing the minor calices, major calices, renal pelvis, and infundibulum
renal sinus
41
a disease characterized by the buildup of fibrous tissue within the retroperitoneum; this mass may involve the abdominal aorta, IVC, ureters, and sacrum
retroperitoneal fibrosis
42
the combination of slow systolic upstroke and a decreased systolic velocity
tardus-parvus
43
muscular bundles
trabeculae
44
a malignant tumor of the urinary tract that is often found within the urinary bladder or within the renal pelvis
transitional cell carcinoma
45
the area within the urinary bladder where the two ureteral orifices and urethral orifice are located
trigone of the urinary bladder
46
a systemic disorder that leads to the development of tumors within various organs
tuberous sclerosis
47
an abnormality in which the distal ureter projects into the urinary bladder
ureterocele
48
a localized collection of urine
urinoma
49
a urinary stone
urolithiasis
50
the retrograde flow of urine from the urinary bladder into the ureter
vesicoureteral reflux
51
a radiographic examination that involves the assessment of the urinary bladder and distal ureter for urinary reflux and other abnormalities
voiding cystourethrogram
52
an inherited disorder characterized by tumors of the central nervous system and the development of cysts within the kidneys, renal cell carcinoma, and pheochromocytoma
von Hippel-Lindau syndrome
53
a rare chronic form of pyelonephritis that is typically the result of a chronic obstructive mass
xanthogranulomatous pyelonephritis
54
the functional unit of the kidney
nephron
55
the kidneys initially develop within the pelvis and ascend into their normal position by _ weeks gestation
9
56
most common location of an ectopic kidney
pelvis
57
4 coverings of the kidney
pararenal fat layer
Gerota's fascia
perirenal fat layer
renal capsule
58
2 parts of the kidney
renal parenchyma
| renal sinus
59
2 parts of the renal parenchyma
renal medulla
| renal cortex
60
the renal medulla is responsible for __________ and includes the ____________
absorption
| renal pyramids
61
the renal cortex is responsible for __________
filtration of the blood
62
4 components of the renal collecting system contained in the renal sinus
minor calices
major calices
renal pelvis
infundibula
63
the renal arteries are branches of the ____________ that are located just below the level of the _____________
abdominal aorta
| SMA
64
which renal vein is longer?
left
65
which renal artery is longer?
right
66
what 3 things may be utilized in blood tests for renal function?
blood urea nitrogen (BUN)
creatinine
lactate dehydrogenase (LDH)
67
an elevation in either BUN or creatinine indicates some form of what?
renal disease
68
typical measurements for kidneys
8-13 cm in length
2-3 cm in AP
4-5 cm in width
69
most common cause of acute renal failure
acute tubular necrosis
70
```
Clinical findings:
elevated BUN and creatinine
oliguria
hypertension
leukocytosis
hematuria
edema
hypovolemia
```
acute renal failure
71
Sonographic findings:
normal kidneys
may appear more echogenic
acute renal failure
72
most common cause of chronic renal failure
diabetes mellitus
73
```
Clinical findings:
diabetes mellitus
malaise
elevated BUN and creatinine
fatigue
hypertension
hyperkalemia
```
chronic renal failure
74
Sonographic findings:
small, echogenic kidneys
loss of normal corticomedullary differentiation
renal cysts may be seen as well
chronic renal failure
75
most common renal mass
simple cyst
76
4 locations of renal cysts
peripelvic - originate from the renal sinus
parapelvic - originates in the renal parenchyma and protrudes into the renal sinus
cortical - located within the cortex
exophytic - project out away from the kidney
77
Clinical findings:
asymptomatic
may have pain
simple renal cyst
78
```
Sonographic findings:
spherical
anechoic mass
smooth walls
posterior acoustic enhancement
no internal echoes
```
simple renal cyst
79
if a cyst does not meet all of the criteria for a simple renal cyst, it is a __________
complex renal cyst
80
autosomal dominant polycystic kidney disease usually shows up in what decades of life?
third or fourth
81
```
Clinical findings:
asymptomatic until the third or fourth decade of life
decreased renal function
urinary tract infections
renal calculi
flank pain
hematuria
palpable abdominal mass
```
autosomal dominant polycystic kidney disease
82
Sonographic findings:
bilateral enlarged kidneys that contain numerous cortical renal cysts
possible cysts identified in the pancreas, liver, and/or spleen
autosomal dominant polycystic kidney disease
83
autosomal recessive polycystic kidney disease is characterized by dilation of the _______________
renal collecting tubules
84
Clinical findings:
may be found in the fetus
clinical findings of renal failure
hepatic disease
autosomal recessive polycystic kidney disease
85
Sonographic findings:
bilateral, enlarged echogenic kidneys
loss of corticomedullary differentiation
autosomal recessive polycystic kidney disease
86
multicystic dysplastic kidney is thought to be caused by what?
an early, first trimester obstruction in the ureter
| if bilateral, it is fatal
87
Clinical findings:
asymptomatic
normal renal function
multicystic dysplastic kidney disease
88
Sonographic findings:
unilateral, smooth-walled, noncommunicating cysts of varying sizes located within the renal fossa
compensatory hypertrophy of the contralateral kidney
multicystic dysplastic kidney disease
89
acquired renal cystic disease is often the result of what?
chronic hemodialysis
90
patients with a history of dialysis and who have acquired renal cystic disease are at an increased risk of developing _________
RCC
91
Clinical findings:
clinical findings of renal failure
history of hemodialysis
acquired renal cystic disease
92
Sonographic findings:
the kidney will appear small initially during end-stage renal disease with some small cysts
with time, the kidneys may enlarge and have numerous small cysts noted throughout the renal parenchyma
acquired renal cystic disease
93
patients with von Hippel-Lindau syndrome have the propensity to develop what other 3 things?
cysts within the kidneys
RCC
pheochromocytomas
94
Clinical findings:
| symptoms of a brain and/or eye tumors
von Hippel-Lindau syndrome
95
```
Sonographic findings:
multiple renal cysts
cysts may be complex and have mural nodules (sign of RCC)
cysts within the pancreas
pheochromocytoma may be present
```
von Hippel-Lindau syndrome
96
Clinical findings:
epilepsy
skin lesions of the face
tuberous sclerosis
97
Sonographic findings:
bilateral renal cysts
bilateral angiomyolipomas
tuberous sclerosis
98
```
Clinical findings:
flank pain
bacteriuria
pyuria
leukocytosis
dysuria
urinary frequency
```
acute pyelonephritis
99
```
Sonographic findings:
kidneys may appear normal
renal enlargement
focal areas of altered echotexture
compression of the renal sinus
```
acute pyelonephritis
100
```
Clinical findings:
pyuria
bacteriuria
fever
flank pain
leukocytosis
```
pyonephrosis
101
Sonographic findings:
hydronephrosis
pus and debris appear as internal, layering, and low-level echoes within the dilated collecting system
pyonephrosis
102
```
Clinical findings:
symptoms of pyelonephritis
high fever
flank pain
leukocytosis
```
renal or perinephric abscess
103
Sonographic findings:
can appear anechoic, hypoechoic, or complex, depending on its contents
gas shadows or dirty shadowing may be present within the mass
renal or perinephric abscess
104
a rare and life-threatning complication of pyelonephritis found more often in patients who have diabetes or who are immunocompromised
emphysematous pyelonephritis
105
which bacteria most commonly causes emphysematous pyelonephritis?
Escherichia coli
106
```
Clinical findings:
diabetes mellitus
immunocompromised patient
fever
flank pain
leukocytosis
```
emphysematous pyelonephritis
107
Sonographic findings:
gas or air within the renal parenchyma
dirty shadowing (reverberation artifact) coming from the renal parenchyma
emphysematous pyelonephritis
108
```
Clinical findings:
flank pain
bacteriuria
pyuria
leukocytosis
dysuria
urinary frequency
```
chronic pyelonephritis
109
Sonographic findings:
| small, echogenic kidneys that have lobulated borders
chronic pyelonephritis
110
most common cause of fungal urinary tract infections
Candida albicans
111
```
Clinical findings:
immunocompromised person
diabetes mellitus, IV drug abuse or long-standing indwelling catheter
infant with an indwelling catheter
flank pain
fever
chills
```
renal fungal disease
112
Sonographic findings:
| fungal balls appear as hyperechoic, nonshadowing, mobile structures within the renal collecting system
renal fungal disease
113
```
Clinical findings:
recent throat infection (acute)
smoky urine
hematuria
proteinuria
fever
hypertension
azotemia
```
glomerulonephritis
114
Sonographic findings:
enlarged kidney(s) of varying echogenicities
prominent renal pyramids
acute glomerulonephritis
115
Sonographic findings:
| small, echogenic kidneys
chronic glomerulonephritis
116
dilation of the calices
caliectasis
117
dilation of the renal pelvis
pelviectasis
118
dilation of the calices and renal pelvis
pelvocaliectasis
119
dilation of the urinary tract occurs ________ to the level of obstruction
proximal
120
the dilation of the renal collecting system secondary to the obstruction of normal urine flow
hydronephrosis
121
6 intrinsic causes of hydronephrosis
urolithiasis
congenital abnormality (vesicoureteral reflux, posterior urethral valves, and ureterovesicular junction)
hematoma (blood clot)
neoplasm
ureteropelvic junction obstruction or ureteral stricture
uereterocele
122
8 extrinsic causes of hydronephrosis
```
benign prostatic hypertrophy
neurogenic bladder
pelvic masses (uterine leiomyoma, ovarian masses, tubo-ovarian abscess, and bowel masses)
pregnancy
retroperitoneal fibrosis
surgery
trauma
urethritis
```
123
4 sources of false-positive hydronephrosis
overdistention of the urinary bladder
parapelvic cysts
prominent renal vein
extrarenal pelvis
124
what are kidney stones most often made of?
calcium oxalate
125
most common location for a stone to become lodged in the urinary tract
the ureterovesicular junction
126
Clinical findings:
hematuria
renal colic
oliguria
urolithiasis
127
Sonographic findings:
echogenic focus that produces acoustic shadowing
"twinkle sign" seen posterior to the stone
hydronephrosis and dilatation of a ureter may be present
urolithiasis
128
most common cause of medullary nephrocalcinosis
medullary sponge kidney
129
```
Clinical findings:
hypercalcemia
hyperparathyroidism
urinary tract infection
history of urinary calculi
```
nephrocalcinosis
130
Sonographic findings:
medullary - echogenic renal pyramids - medullary sponge kidney
cortical - echogenic foci within the cortex
nephrocalcinosis
131
a benign mass that appears sonographically similar to its malignant counterpart
renal cell adenoma
132
renal cell adenomas typically measure less than ___
1 cm
133
Clinical findings:
asymptomatic
may complain of hematuria
renal adenoma
134
Sonographic findings:
hyperechoic, vascular mass with internal calcifications
may produce acoustic shadowing
renal adenoma
135
benign renal tumor that is often found in men in their 60s
oncocytoma
136
Sonographic findings:
isoechoic, hyperechoic, or hypoechoic mass
may also contain a hypoechoic central scar
oncocytoma
137
a renal hamartoma is also called an:
angiomyolipoma
138
patients with tuberous sclerosis tend to have multiple and bilateral ______________
angiomyolipomas
139
Clinical findings:
asymptomatic
tuberous sclerosis
hematuria, pain, and/or hypertension secondary to hemorrhage
angiomyolipoma
140
Sonographic findings:
solid, hyperechoic mass
may produce acoustic shadowing
tend to be multiple and bilateral with tuberous sclerosis
angiomyolipoma
141
Sonographic findings:
| small, hyperechoic renal mass encountered in the third or fourth decade of life
renal hemangioma
142
Sonographic findings:
well-circumscribed, hyperechoic mass usually measuring less than 5 mm in diameter
most often found in women
renal lipoma
143
```
Clinical findings:
anorexia
flank pain
gross hematuria
hypertension
palpable mass
smoker
weight loss
```
renal cell carcinoma
144
Sonographic findings:
hypoechoic or isoechoic solid mass on the kidney
check the renal vein and IVC for tumor invasion
renal cell carcinoma
145
where is transitional cell carcinoma of the kidney usually found?
in the renal pelvis
146
Clinical findings:
hematuria
pain secondary to renal obstruction
transitional cell carcinoma of the kidney
147
Sonographic findings:
hypoechoic or isoechoic mass within the renal sinus
hydronephrosis may be present
transitional cell carcinoma of the kidney
148
2 places cancer most often metastasizes to the kidneys from:
lungs
| breast
149
```
Clinical findings:
history of primary cancer (often lung or breast)
hematuria
fever
weight loss
```
metastases of the kidney
150
Sonographic findings:
bilateral, hypoechoic or hyperechoic masses
lymphoma or leukemia can manifest as an enlarged hypoechoic kidney
metastases of the kidney
151
```
Clinical findings:
smoker
high blood pressure
high cholesterol
diabetes
hypertension that does not respond to treatment
```
renal artery stenosis
152
Sonographic findings:
thickening and calcification of the renal artery may be noted
renal/aorta ratio that is greater than 3.5
possibly a tardus-parvus spectral waveform downstream from the stenosis
renal artery stenosis
153
Clinical findings:
pain
hematuria
(may be caused by renal tumors, trauma, renal infection, or be seen after a kidney transplant)
renal vein thrombosis
154
```
Sonographic findings:
heterogeneous renal echotexture
enlarged renal vein
absent renal vein Doppler signals
thrombus may not be seen
```
renal vein thrombosis
155
4 causes of congenital hydronephrosis
ureteropelvic junction obstruction
vesicoureteral reflux
posterior urethral valves
prune belly syndrome
156
most common cause of congenital hydronephrosis in infants and children
ureteropelvic junction obstruction
157
folds of excessive urethral tissue found exclusively in males
posterior urethral valves
158
```
Clinical findings:
may be asymptomatic
most commonly found in young females
bacteriuria
fever
```
vesicoureteral reflux
159
most common solid malignant pediatric mass
Wilms tumor (nephroblastoma)
160
when is a Wilms tumor most often discovered?
before age 5, with a mean age of 3
161
```
Clinical findings:
palpable abdominal mass in pediatric patient
abdominal pain
hematuria
fever
hypertension
```
Wilms tumor
162
Sonographic findings:
large, solid, mostly echogenic masses that may contain anechoic or hypoechoic areas
evaluate IVC and renal vein for tumor invasion
Wilms tumor
163
3 pediatric urachal anomalies
patent urachus
urachal cyst
urachal sinus
164
```
Clinical findings:
history of some form of trauma to the kidney(s) (blunt trauma, stab wound, biopsy, and lithotripsy)
flank pain
abdominal pain
hematuria
decreased hematocrit
```
renal hematoma
165
Sonographic findings:
variable appearance depending on the stage of the blood and location
blood may accumulate under the capsule (subcapsular), in the perinephric area (in Gerota's fascia), pararenal area (anterior or posterior), or intramuscular (in the psoas muscle)
if chronic, may calcify and produce acoustic shadowing
renal hematoma
166
where are transplanted kidneys placed?
in the right or left lower quadrant
167
4 things a postrenal transplant fluid collection could be:
lymphocele
urinoma
hematoma
abscess
168
Sonographic findings:
echogenic focus within the ureter that produces acoustic shadowing
dilatation of the ureter proximal to the obstruction
ureteral stone
169
ureteroceles are often associated with what?
duplicated collecting systems
170
Sonographic findings:
anechoic, balloonlike structure within the lumen of the urinary bladder near the ureterovesicular junction
can be ectopic in location
ureterocele
171
Sonographic findings:
large, anechoic tubular structure that extends from the kidney to the urinary bladder; only a section may be enlarged however
megaureter and hydroureter
172
4 layers of the bladder, from inner to outer
mucosa
submucosa
muscularis
serosa
173
what muscle controls the appropriate emptying of the urinary bladder?
detrusor muscle (located within the muscularis portion of the wall)
174
when the bladder wall is thickened, its diameter will exceed ____ in a distended state
4 mm
175
bladder volume formula
L x W x H x 0.56
176
Clinical findings:
past history of brain or spinal trauma, congenital spinal abnormalities, or diabetes
unnecessary urgency to void
rarely feel the need to urinate
neurogenic bladder
177
Sonographic findings:
urinary bladder wall thickening
trabeculae of the bladder wall
postvoid images will show excessive urinary retention
the patient may have a distended bladder but does not feel the need to urinate
bladder stones may be present
neurogenic bladder
178
Sonographic findings:
| anechoic outpouching of the bladder wall
bladder diverticulum
179
```
Clinical findings:
dysuria
urinary frequency
lower abdominal pain
nocturia
hematuria
```
cystitis
180
Sonographic findings:
bladder wall may appear focally or diffusely thickened, measuring greater than 4 mm in thickness
bladder may contain echogenic, layering material within its lumen
cystitis
181
Sonographic findings:
| echogenic, mobile, shadowing foci within the lumen of the urinary bladder
bladder stones
182
Sonographic findings:
| echogenic, nonshadowing mass that may be mobile or adhered to the wall of the bladder
blood clots in the bladder
183
the most malignant tumor of the bladder
transitional cell carcinoma (TCC)
184
Clinical findings:
gross hematuria
may urinate blood clots
transitional cell carcinoma of the bladder
185
Sonographic findings:
smooth or papillary hypoechoic mass that projects into the lumen of the bladder
a solid tumor will not be mobile and will often demonstrate vascularity
transitional cell carcinoma of the bladder
186
```
What is the functional unit of the kidney?
A. nephron
B. medulla
C. cortex
D. Bowman's capsule
```
nephron
187
```
The protective capsule of the kidney is referred to as:
A. Glisson capsule
B. perirenal capsule
C. renal capsule
D. renal cortex
```
renal capsule
188
```
The vessel located anterior to the abdominal aorta and posterior to the superior mesenteric artery is the:
A. celiac artery
B. left renal artery
C. right renal vein
D. left renal vein
```
left renal vein
189
```
All of the following are clinical findings of acute renal failure except:
A. hematuria
B. hypertension
C. oliguria
D. decreased BUN and creatinine
```
decreased BUN and creatinine
190
Which of the following is the most common cause of chronic renal failure?
A. hypertension
B. diabetes mellitus
C. autosomal recessive polycystic kidney disease
D. acute tubular necrosis
diabetes mellitus
191
```
The inherited disorder associated with the development of tumors of the central nervous system and orbits, renal cysts, and adrenal tumors is:
A. tuberous sclerosis
B. tuberculosis
C. von Hippel-Lindau syndrome
D. multicystic dysplastic kidney disease
```
von Hippel-Lindau syndrome
192
Which of the following is the most common cause of acute renal failure?
A. hypertension
B. diabetes mellitus
C. autosomal recessive polycystic kidney disease
D. acute tubular necrosis
acute tubular necrosis
193
```
All of the following are characteristics of a complex cyst except:
A. internal echoes
B. smooth walls
C. mural nodules
D. septations
```
smooth walls
194
Which of the following best describes the sonographic appearance of a kidney affected by autosomal recessive polycystic kidney disease?
A. bilateral enlarged, echogenic kidneys
B. unilateral, smooth-walled, noncommunicating cysts of varying sizes located within the renal fossa
C. small, echogenic kidneys
D. numerous large, complex renal cysts
bilateral enlarged, echogenic kidneys
195
```
The systemic disorder associated with epilepsy that leads to the development of solid tumors in various organs including angiomyolipomas of the kidneys is:
A. tuberous sclerosis
B. tuberculosis
C. von Hippel-Lindau syndrome
D. multicystic dysplastic kidney disease
```
tuberous sclerosis
196
```
The presence of purulent material within the renal collecting system is termed:
A. pylotosis
B. pyelonephritis
C. pyonephrosis
D. emphysematous pyelonephritis
```
pyonephrosis
197
```
Clinical findings of glomerulonephritis include all of the following except:
A. proteinuria
B. throat infection
C. azotemia
D. hypercalcemia
```
hypercalcemia
198
```
Which of the following is not considered an intrinsic cause of hydronephrosis?
A. ureterocele
B. urethritis
C. urolithiasis
D. ureteropelvic junction obstruction
```
urethritis
199
```
Clinical findings of nephrocalcinosis include all of the following except:
A. urinary tract infections
B. urinary calculi
C. hyperparathyroidism
D. weight loss
```
weight loss
200
Which of the following renal conditions is associated with the development of cysts within the pancreas and liver?
A. autosomal recessive polycystic kidney disease
B. autosomal dominant polycystic kidney disease
C. multicystic dysplastic kidney disease
D. acquired renal cystic disease
autosomal dominant polycystic kidney disease
201
```
Which of the following locations is the most common location for a urolithiasis to become lodged?
A. ureteropelvic junction
B. midureter
C. urethra
D. ureterovesicular junction
```
ureterovesicular junction (UVJ)
