Fetal Genitourinary System

Question 1

The fetal kidneys develop within the pelvis and ascend into their normal position by:

Answer 1

9 weeks

Question 2

By week ____ fully functional kidneys exist.

Answer 2

10

Question 3

If kidneys fail to ascend into the normal position, they are most often located :

Answer 3

within the pelvis

Question 4

Most common renal anomaly is the :

Answer 4

duplex collecting system

Question 5

The kidneys can be sonographically identified as early as :

Answer 5

11-12 weeks

Question 6

The gonads develop in the _______

Answer 6

upper fetal abdomen and descend into the pelvis

Question 7

The testicles move down into the scrotum during ____ month of gestation.

Answer 7

7th

Question 8

The fetal bladder can be seen as early as:

Answer 8

12 but should always be seen by 15 weeks

Question 9

The urinary bladder normally fills and empties once every :

Answer 9

30 - 45 mins

Question 10

VACTERL stands for:

Answer 10

vertebral, anal atresia, cardiac anomalies, tracheoesophageal fistula or esophageal atresia, renal anomalies, limb anomalies

Question 11

Patients are considered to have VACTERL association if:

Answer 11

3 organs systems involved have abnormalities

Question 12

Renal abnormalities are the most frequent cause of :

Answer 12

oligohydramnios

Question 13

Urine comprises the greater part of the amniotic fluid after:

Answer 13

14 weeks

Question 14

failure of a kidney to form:

Answer 14

renal agenesis

Question 15

Sonographic finding when the kidney is absent in the abdomen, the adrenal gland can be noted in a parallel flattened position, sonographically known as:

Answer 15

“lying down” adrenal sign

Question 16

When there is an absence of the kidney, and you place color doppler over the renal artery branches of the aorta there will be:

Answer 16

no identifiable renal artery branches

Question 17

Bilateral renal agenesis, aka:

Answer 17

potter’s syndrome

Question 18

Non-visualization of the urinary bladder and kidneys, with oligohydramnios, are considered a consistent finding with:

Answer 18

bilateral renal agenesis

Question 19

Before making the conclusion of unilateral renal agenesis, the sonogrpaher should always analyze the:

Answer 19

fetal pelvis for a pelvidc kidney

Question 20

In presence of unilateral renal agenesis, the contralateral kidney will :

Answer 20

enlarge, a condition known as compensatory hypertrophy

Question 21

In order for an autosomal recessive disease to be passed to the fetus,

Answer 21

both parents must be carriers of the disease.

Question 22

In the case of autosomal dominant disease how many parents must be the carrier(s) of the disease with the gene being dominant, in order to pass it to the fetus:

Answer 22

one

Question 23

The typical sonographic findings of a fetus affected by ARPKD:

Answer 23

bilateral enlarged, echogenic kidneys, non detectable urinary bladder, and oligohydramnios

Question 24

Condition associated with ARPKD which is a fatal disorder that is associated with renal cystic disease, occipital cephalocele, and polydactyly

Answer 24

meckel gruber syndrome

Question 25

Fetuses with trisomy ____ and trisomy ____ may also have polycystic kidney disease.

Answer 25

13, 18

Question 26

Cysts with ARPKD are:

Answer 26

microscopic

Question 27

Cysts are not identifiable in ARPKD but are evident in:

Answer 27

multicystic dysplastic kidney

Question 28

Sonographic appearance of fetal kidneys with ADPKD:

Answer 28

enlarged echogenic kidneys

Question 29

Distinguising difference between ARPKD and ADPKD

Answer 29

Urinary bladder is often present and there is normal amniotic fluid with ADPKD

Question 30

ADPKD does not typically manifest until:

Answer 30

5th decade of life

Question 31

MCDK disease is thought to be caused by an early, First trimester:

Answer 31

obstruction of the ureter

Question 32

Sonographic findings of MCDK is :

Answer 32

identification of unilateral or bilateral multiple, smooth-walled, noncommunicating cyst of varying sizes in the area of the renal fossa

Question 33

There is no normal functioning ______ present in the kidney affected by MCDK

Answer 33

renal tissue

Question 34

Most cases of MCDK are ______

Answer 34

unilateral | fatal if bilateral

Question 35

A _______ or a severe _____ _________ early in gestation can lead to bilateral obstructive cystic dysplasia, in which oligohydramnios will be present.

Answer 35

ureterocele, or severe bladder outlet obstruction

Question 36

Unilateral obstructive cystic dysplasia is most often caused by a:

Answer 36

pelviureteral junction or vesicoureteral junction obstruction

Question 37

An obstruction of the fetal urinary tranct can lead to :

Answer 37

distension of the bladder, ureters, and renal collecting system

Question 38

If there is an obstruction at the region where the ureter meets the bladder, ten structures where will be dilated?

Answer 38

proximal to the obstruction

Question 39

Most common fetal abnormality noted during obstetric sonogram:

Answer 39

hydronephrosis

Question 40

Enlargement of the bladder is called:

Answer 40

megacystis

Question 41

Dilation of the ureter may be referred to as:

Answer 41

megaureter or hydroureter

Question 42

Dilation of the renal pelvis is termed:

Answer 42

pelviectasis

Question 43

Measurement of the renal pelvis is made in the AP plane and should not exceed:

Answer 43

7 mm before 20 weeks | 10 mm after 20 weeks

Question 44

Three most common areas where obstruction occurs

Answer 44

ureteropelvic junction, ureterovesicular junction, and the urethra

Question 45

Most common cause of hydronephrosis in the neonate and the most common form of fetal renal obstruction :

Answer 45

UPJ obstruction

Question 46

UPJ obstruction is usually :

Answer 46

unilateral and more common in males

Question 47

Sonographic appearance of UPJ obstruction:

Answer 47

dilation of the renal pelvis and renal calices

Question 48

Situation in which there is a blockage of the flow of urine out of the urinary bladder:

Answer 48

bladder outlet obstruction

Question 49

The _______ sign is seen when there is dilation of the urinary bladder and posterior urethra.

Answer 49

keyhole

Question 50

Describes the result of the abdominal wall musculature being stretched by the enlarged bladder. (Typically caused by megacystis, a massively dilated urinary bladder):

Answer 50

Prune Belly syndrome

Question 51

The triad for Prune Belly syndrome:

Answer 51

absent abdominal musculature, undescended testis, and urinary tract abnormalities

Question 52

Renal collecting system and ureter will be dilated with:

Answer 52

UVJ obstruction

Question 53

When UVJ is bilateral amniotic fluid will appear as

Answer 53

oligohydramnios

Question 54

Anomaly where the bladder is located outside of the pelvis:

Answer 54

bladder exstrophy

Question 55

The sonographic finding of bladder exstrophy :

Answer 55

lower abdominal wall mass inferior to the umbilicus

Question 56

Embryonic structure that develops into the rectum and urogenital sinus :

Answer 56

cloaca

Question 57

With cloacal exstrophy, AKA OEIS complex there is:

Answer 57

omphalocele, bladder exstrophy, imperforate anus, and spina bifida

Question 58

With cloacal exstrophy both _____ and _____ are located outside of the lower abdominal wall.

Answer 58

bladder and distal colon

Question 59

Most common solid fetal renal mass is the :

Answer 59

mesoblastic nephroma/ hamartoma

Question 60

Mesoblastic nephroma/ hamartoma will typically appear as:

Answer 60

solid, homogeneous mass within the renal fossa and may completely replace the kidney

Question 61

The sex of the embryo depends upon the :

Answer 61

male gamete

Question 62

XX is :

Answer 62

female offspring

Question 63

XY is:

Answer 63

male offspring

Question 64

Birth defect in which the sex of the fetus cannot be determined:

Answer 64

ambiguous genitalia

Question 65

Findings of abnormal genitalia in the male are:

Answer 65

hydroceles, micropenis, hypospadias, and undescended testicles

Question 66

Abnormal ventral curvature of the penis as a result of a shortened urethra that exits on the ventral penile shaft:

Answer 66

hypospadias

Question 67

Most common female finding of abnormal genitalia :

Answer 67

clitoromegaly

Question 68

Most common malignant abdominal mass and primary location in neonates is the:

Answer 68

neuroblastoma, located primarily within the adrenal gland

Question 69

Adrenal glands may _______ within the fetus, resembling a mass.

Answer 69

spontaneously hemorrhage