Chapter 7: Urinary Tract Flashcards
What is the most common location of an ectopic kidney
Pelvis
Which kidney is longer
Left
Whats the innermost covering of the kidney
Renal capsule
After the renal capsule, what are the three layers surrounding the kidney, from innermost to outermost
Perirenal fat
Gerota fascia
Pararenal fat
Whats the order of the vascular anatomy of the kidney, starting at the hilum
Segmentals
Interlobar
Arcuate
Interlobular
What is the most common congenital anomaly of the urinary tract
Duplicated collecting system (2 renal sinuses)
The pyramids of the kidney are separated by the columns of ______
Bertín
What is compensatory hypertrophy renal variant
Cuando un riñón está jodio y el otro se agranda
What is a crossed fused ectopic kidney
Both kidneys are fused on the same side of the body
What is junctional parenchymal renal defect
Incomplete fusion of 2 components of the kidney. Echogenic line separating them
What is renal sinus lipomatosis
Excessive fat in renal pelvis making it large and echogenic
What is the most common place for a stone to lodge in the urinary tract
Ureterovesicle junction
What is a ureterocele
Dilation of the ureter as it enters the bladder
Looks like an anechoic balloon in the lumen of the bladder
What is a megaureter
Congenital large ureter
What is a hydroureter
Large ureter associated with obstruction
What are the 4 layers of the bladder wall from inner to outer
Mucosa
Submucosa
Muscularis
Serosa
The destrusor muscle is in charge of emptying the bladder and is located in what layer of the bladder
Muscularis
A distended bladder wall should measure less than
4mm
What is a neurogenic bladder
Poorly functioning bladder secondary to neurological disorder that affects the detrusor muscle
What is a bladder dicerticulum
Outpouching in the bladder wall como un globo pero para afuera associated with obstruction
What is cystitis
Inflammation of the bladder and thickening of the wall (mas de 4mm)
What is the most common malignant tumor of the bladder
Transitional cell carcinoma of the bladder
Describe transitional cell carcinoma of the bladder
Smooth or papillary hypo/hyperechoic non mobile vascular mass that projects into lumen
Describe acute renal failure
Sudden decrease in renal function, often caused by acute tubular necrosis
What does acute renal failure look like on ultrasound
Normal kidneys (maybe more echogenic)
Hydroneprhosis sometimes
What are clinical findings of acute renal failure
Elevated BUN and creatinine
Oliguria
Hematuria
Hypertension
Leukocytosis
Edema
Hypovolemia
What is the most common cause for chronic renal failure
Diabetes mellitus
Chronic renal failure will lead to end stage renal _______
Disease
Describe autosomal dominant polycystic kidney disease
Seen in ADULTS
Most common cause of renal failure
Associated with polycystic liver disease
Bilat enlarged kidneys that contain multiple cysts
Describe autosomal recessive polycystic kidney disease
Seen in CHILDREN
Dilation of the renal collecting tubules
Pts die
Clinical findings of renal failure
Describe multicystic dysplastic kidney disease
Asymptomatic Unilateral huge cysts everywhere in that kidney making it non functional
The other kidney takes over and becomes enlarged
Describe acquired renal cystic disease
Can result from hemodyalisis
Development of cysts
Clinical findings of chronic renal failure
What is Von hippel lindau syndrome
Tumors in the central nervous system, cysts in the kidneys and pancreas, renal cell carcinoma and adrenal gland tumors
What is tuberous sclerosis
Bilateral renal cysts and angiomyolipomas in the kidneys. Associated with renal cystic disease
Shows skin lesions of the face and epilepsy
What is acute pyelonephritis
Inflamed kidneys secondary to infection
Most common in woman
What is pyonephrosis
Pus in the collecting system of the kidney
Will show hydronephrosis too
What does chronic pyelonephritis look like
Small echogenic kidneys with lobulated borders and renal scar and dilated calyx
What is a renal or perinephric absess
Can occur secondary to pyelonephritis inside the kidney or adjacent to it (perinephric)
May show gas
What is emphysematous pyelonephritis
Rare complication of pyelonephritis where there is gas in the renal parenchyma
Can be fatal
What is xanthogranulomatous pyelonephritis
When renal parenchyma is replaced with granulomatous tissue
Typically caused by chronic urinary tract obstruction and infection
What is the most common cause for renal fungal disease
Candida albicans
What does renal fungal disease look like
Hyperechoic mobile nonshadowing fungal balls in the renal collecting system
What is glomerulonephritis
Caused by a recent throat infection like strep or other conditions
Kidneys can slowly shut down
Acute- big echogenic kidneys
Chronic- small echogenic kidneys
A parasitic UTI is mits commonly developed from what parasite
Schistosomiasis. A parasite that enters the skin
Causes bladder wall thickening
Parasitic UTIs can also be caused by what parasite
Echinococcus granulosus
Develops a hydatid cyst
Common in Middle East, Australia, Mediterranean
What does a hydatid renal cyst look like
Can contain a daughter cyst with debris or appear complex or simple
What is hydronephrosis (aka pyelocaliectosis)
Dilation of the renal collecting system secondary to obstruction
Hydronephrosis can alter renal artery index making it greater than
0.7
Urolithiasis is most frequently found in men and it can cause ________ pain in males
Testicular
What is a staghorn calculus
A stone that fills in and takes the shape of the renal pelvis
What is the most common location for a urinary stone to lodge
Ureterovesicle junction (near the bladder)
What is nephrocalcinosis
Accumulation of calcium in the kidney
Can be medullary or cortical
Medullary nephrocalcinosis can be caused by what defect
Medullary sponge kidney
What are some specific clinical findings of nephrocalcinosis
Hypercalcemia
Hyperparathyroidism
An angiomyolipoma is also called _________ and is the most common benign hyperechoic renal tumor
Hamartoma
What is an oncocytoma
Second most common benign renal mass
Often found in men 60 years or older
Variable sono appearance
What’s a renal hemangioma
Benign small hyperechoic mass of blood vessels that develop around 30-40 years old
What is a renal lipoma
Benign hyperechoic fatty tumor often found in women measuring less than 5mm
What is a renal adenoma
Benign vascular hyperechoic mass with calcifications that appears similar to its malignant counterpart RCC
Less than 1cm
What does a renal fracture look like
Linear absence of echoes or like an anechoic line
Renal cell carcinoma is also called what other names
Hypernephroma
Adenocarcinoma
Hippel lindau disease is associated with _______ cell carcinoma
Renal
What does renal cell carcinoma look like
Varying echogenicity solid mass, or complex cyst
Check for metastasis to IVC or liver
What is renal transitional carcinoma
Malignant tumor found in renal pelvis causing focal dilation of cálices
Hydronephrosis can be present
Metastases to the kidney most often comes from where
Lungs or breast
What is nutcracker syndrome
Entrapment of the left renal vein as it passes the SMA and aorta
Make pts may complain of testicle pain
And females may suffer from pelvic congestion syndrome
With renal artery stenosis, sonogram will show thickening and calcification of renal artery and renal-aorta ratio of ____
3.5
With renal vein thrombosis, what’s gonna happen to that kidney
It will increase in size and be heterogenous
What is an allograft
Transplanted kidney
What is the most common complication of a transplanted kidney
Renal artery stenosis
What is the most common cause for pediatric congenital hydronephrosis
Ureteropelvic junction obstruction
Pediatric vesicoureteral reflux is commonly caused by
Abnormal angle of insertion of the distal ureter into the bladder so the valve doesn’t work properly
What is the Weigert-Meyer rule
It says that pts with duplicated pelvicaliceal systems and complete ureteral duplication may suffer from vesicoureteral reflux
Y que el sistema más arriba es siempre el del problema
Pediatric patients that develop Wilma tumor usually have what syndrome
Beckwith wiedemann syndrome
The urachus connects the _______ to the umbilicus during fetal development and then it’s supposed to close
Bladder
If the urachus doesn’t close during fetal development it can cause what
Anomalies
Including cysts, diverticulum, patent urachus (fistula) and urachus sinus
