common small parts pathology test part 2 Flashcards
bilateral process which results in small, echogenic kidneys with noticeable loss of parenchymal thickness. Cortical thickness = minimum measurment of 1cm. May be difficult to distinguish from surrounding perinephric fat and retroperitoneal structures
chronic medical renal disease AKA chronic renal failure
benign, solitary renal tumor composed of blood vessels smooth muscle and fat cells
hypoechoic mass found in the renal cortex and can have posterior acoustic enhancement
no color doppler within tumor
angiomyolipoma
angiomyolipoma
80% in rt kidney and 80% in women
angio-blood vessels
myo-smooth muscle
lipoma-fat cells
multiple cysts of varying size located in the renal cortex and medulla. Bilateral, and can cause massively enlarged, asymmetrical kidneys. Often assocaited with cysts in the liver, spleen, pancreas and several small parts.
autosomal dominant polycystic kidney disease
solid parenchymal mass, isoechoic or hypoechoic, disrupt the renal cortex, peripheral vascularity (basket sign)
renal carcinoma
IVC and renal veins should be imaged for evidence of tumor extension
developmental anomaly of distal collecting ducts, causing urinary stasis with stone formation, usually asymptomatic and not found until young adulthood. Enlarged echogenic medullary (women in 20’s with no symptoms)
medullary sponge kidney
diffuse calcuim deposits with the medulla, often seen in conjunction with MSK. Other primary causes are hyperparathyroidism, chronicnephritis, sickle cell (old man)
nephrocalcinosis
most common medical renal disease to cause acute renal failure. Would be differential diagnosis. Thinned cortex with enlarged, echogenic globs of medullary tissue (child who is dehydrated and has a fever)
acute tubular necrosis
outpouchings of the ladder wall, more commonly seen in older men w/ bladder outlet obstruction, neurogenic bladder disease or paraplegics
diverticulum
irregular, echogenic mass that projects into the lumen of the bladder or as a focal thickening of the wall. Will have blood flow
transitional cell carcinoma (95% of bladder tumors)
echogenic foci along bladder wall w/ posterior shadowing
bladder stones
echogenic parenchyma with loss of distinct medurllary
nephritis
necrosis of the glomerulus, cause is streptococcal bacteria
glomerulonephritis
network of capillaries which filters blood into the renal tubule
glomerulus
an infection of the calyces and renal pelvis, causes UTI, reflux, obstruction, diabetes. Possible to have focal pyelonephritis which appears as a focal echogenic area within the kidney characterized by lack of vascularity with the infected area.
pyelonephritis
most common kidney infection
pyelonephritis
if you put color on the kidney and part of it has color and part is hypoechoic
focal nephritis
most common ectopic kidney
pelvic kidney
bilateral fusion anomaly of the lower poles of the kidney which occurs during fetal development. Kidneys are closer to the spine and the inferior poles lie more medial.
horseshoe kidney
increased deposits of fat in renal sinus, renal cortex appears thinned. Appearance resembles chronic renal insufficiency disease.
sinus lipomatosis
enlarged kidneys with tiny cysts in the medullary and cortical regions, associated with billiary ectasia and hepatic fibrosis. Usually bilateral
autosomal recessive polycystic kidney disease
intact cortical rim, metaastatic from lymphoma
lymphoma
smooth, on stalk, do not shadow, do not move, most common tumor of gallbladder
polyps
GB-hyperplastic wall changes more echogenic than polyps, do not move, have ring down or comet tail artifact
adenomhyomatosis
GB-echogenic foci, multiple or single, shadowing, moveable
gallstones
GB packed with stones, no visible bile within the gallbladder lumen, very distinct posterior shadowing behind a thick, echogenic rim
Wall Echo Shadow (WES)
the whole wall of the gallbladder in incristed with calcium. Similar patter of distinct posterior shadowing in the area of the GB yet often w/o the heavy irregular echogenic anterior rim
porcelain gallbladder
mildly echogenic bile, can float, move as a ball, contain highly echigenic tiny foci can be seen along the gallstones
sludge
positive murphys sign, thickened wall with sonolucent area between the walls
acute cholecystitis
transient RUQ pain with no positive murphys sign more common than acute, is the result of multiple episodes of acute and with fibrosis developing in the wall
chronic cholecystitis
occurs before intrahepatic blockage of the distal common bile duct and eventual dilated intrahepatic ducts, blockage at the portahepatis (common hepatic duct) will demonstrate a normal common bile duct with intrahepatic ductal dilatation, which is characterized by the appearance of too many tubes or double barrel sign of dilated ducts alongside the portal veins
dilated common duct extrahepatic
always check for the source and location of the ductal obstruction
blood filled channel within the walls of the aorta
occurs primarily in the thoracic aorta
marfans stretching disorder of all arterial vessels
dissecting aneursyms
large, 5010cm, connected to aorta by mouth or channel, usually filled with thrombus or clot
saccular aneursyms
most common general widening of aorta, distal, atherosclerosis
fusiform aneursyms
pulsatile hematoma
results from interventional procedures
punctured artery fails to seal off
Ultrasound be used to seal off the leak with compression
pseudo aneursyms
occurs from the bell clapper deformity where the tunica vaginalis completely surrounds the testis, epidiymis and distal spermatic cord lacking the bare area along the posterior scrotal wall
torsion
what side do you put color on first when examining torsion
unaffected side
affected testis is swollen with a mildly heterogeneous echotecture however, echogenicity remains similar to unaffected side
early torsion
affected testis becomes hypoechic and swollen indicating testicular ischemia
venous flow is affected 1st causing occluded veins, followed by arterial obstruction
once arterial flow ceases, tissue necrosis occurs and the affected organ becomes hypoechoic in sonographic appearance
late torsion
used to amplify the color signal, to optimize setting increase until noise is present and then slowly decrease until noise disappears
color gain
the setting that controls the sensitivity of the system to display slow flow. This adjustment will determine flow, direction, and quality.
scale 9pulse repetition frequency)
like and elastic eraser. Often automatically adjusted when changing the scale (PRF) turn up to reduce ghosting artifact, turn down to enhance flow sensitivity
wall filter
size will determine the line density. When large or placed deep in the image, more scan lines are needed and more time is required to complete each image
color box
abnormal dilatation of the veins of the pampiniform plexus in the spermatic cord
varicocele
caused by incompetent valves within the spermatic vein
more common on the left due to the left spermatic vein empting into the left renal vein
primary varicocele
more common in men over 40
result of renal hydronephrosis, abdominal mass or liver cirrhosis and portal hypertension
secondary varicoceles
a collection of serous fluid and is the most common cause of painless scrotal swelling
hydrocele
appears as anechoic fluid at lower frequency settings but may have some low level echoes at higher frequencies and higher hynamic range
infected __________ may have increased internal echoes
appearance of hydrocele
a bilateral codition associated with an increased risk of malignancy and infertiltiy, Calcifications are smaller than 3mm and apppear w/o shadowing. Higher incidence in men with a history of cryptorchidism (undescended testis). Must have more than 5 on a single image
microlithiasis
most common kind of testicular carcinoma
95% are germ cell, most often seminoma
occurs most frequently between ages 20-35
patients present with a painless, palpable testicular lump
testicular carcinomas
hypoechoic, homogenous with smooth borders (testis)
seminomas
most common cause of acute scrotal pain in adults
epididymitis
common cause of epididymitis
urinary tract infection or STD
symtoms of epididymitis
increasing pain over several days with fever an doften a urethral discharge
infection will spread to the testis in about 1/3 of cases which if orchitits
hyperemia presenting as increased color doppler within the testis
