Flashcard Davies Abdomen 5 Flashcards by Billie Harney

What is the most common cause of acute renal failure?

acute tubular necrosis

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Causes of acute tubular necrosis

shock, trauma, sepsis, and drug toxicity

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_____ and _____ may be seen associated with acute tubular necrosis

renal enlargement

increased resistive index

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Sonographically, how is obstructive nephropathy differentiated from nonobstructive nephropathy?

Intrarenal resistivity index greater than 0.7 only relevant to acute obstruction

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obstructive nephropathy is also known as

hydronephosis

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Nonobstructive nephropathy will have resistivity index values of less than ____

0.7

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Obstructive nephropathy will have resistivity index values of greater than ___

0.7

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What genitourinary tract anomaly is commonly associated with a contralateral UPJ obstruction?

unilateral multicystic dysplastic kidney

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Unilateral multicystic displastic kidney is commonly associated with a contralateral ______

ureteropelvic junction obstruction

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most common cause of obstruction in patients with acute flank pain

renal calculi

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Name three common locations within the urinary tract for obstruction from a renal calculi

ureterovesical junction

ureteropelvic junction

ureteric obstruction at level of pelvic inlet

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What is the most common location for an obstruction from a renal calculi?

ureterovesical junction

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a measurement used to evaluate renal transplants, assess suspected hydronephrosis, evaluate medical renal disease, and evaluate suspected renal neoplasms

resistive index

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What is resistive index?

a measurement used to evaluate renal transplants, assess suspected hydronephrosis, evaluate medical renal disease, and evaluate suspected renal neoplasms

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What is the formula for resistive index?

peak systolic frequency - end diastolic frequency / peak systolic frequency

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peak systolic frequency - end diastolic frequency / peak systolic frequency

resistive index

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Describe the waveform characteristics of the arterial side of an arteriovenous fistula

demonstrates an abnormally low resistive arterial flow pattern

a waveform with increased and sustained diastolic flow

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Describe the waveform characteristics of the venous side of an arteriovenous fistula

a waveform with increased velocity, pulsatility and with spectral broadening due to turbulence

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List four sonographic criteria for determining renal artery stenosis

kidney size less than 9 cm in length

peak main renal artery velocity > 180 cm/s

renal artery/aorta ratio >3.5

intrarenal parvus tardus waveform

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Describe the sonographic appearance of a ureterocele

round, cystic structures that project into the bladder lumen at the ureterovesical junction

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Ureteroceles appear as round, cystic structures that project into the bladder lumen at the ______

ureterovesical junction

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Name the structure that connects the apex of the bladder to the umbilicus

median umbilical ligament (urachus)

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The median umbilical ligament is also known as the:

urachus

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The urachus is also known as the:

medial umbilical ligament

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The median umbilical ligament suspends the bladder by connecting the bladder's ___ to the ____

apex umbilicus

The urachus lies in the:

space of Retzius

What is the term that describes cystic dilatation of the urachus?

urachal cyst

Cystic dilatation of the median umbilical ligament is termed:

urachal cyst

A _____ is seen as an echo-free tubular structure in the lower abdomen that extends from the umbilicus to the dome of the bladder

urachal cyst

A urachal cyst is seen as an echo-free tubular structure in the lower abdomen that extends from the _____ to the ____

umbilicus dome of the bladder

What object is placed in the inferior vena cava to prevent the ascension of lower extremity thrombus into the lungs?

Inferior vena cava filters (Greenfield filter)

Inferior vena cava filters are also known as

Greenfield filter

Greenfield filters are also known as

Inferior vena cava filters

What is the purpose of an inferior vena cava filter?

prevent the ascension of thrombus into the lungs

What role can ultrasound play in the evaluation of IVC filters?

can determine the location of the inferior vena cava filter allows detection of complications

The proper placement of a Greenfield filter should be in a location:

inferior to the renal veins

Complications of Greenfield filters

thrombosis around the filter or perforation through the IVC wall, which may be associated with a retroperitonal hematoma

What is the sequence of branching renal arteries from the aorta to the renal capsule

main renal artery segmental arteries interlobar arteries arcuate arteries interlobar arteries

Which arteries of the kidneys are positioned between the medullary pyramids

interlobar arteries

Interlobar arteries are positioned:

between the medullary pyramids

Which arteries of the kidney are parallel to the base of the medullary pyramids

arcuate arteries

Arcuate arteries are located:

parallel to the base of the medullary pyramids

_____ is the most common organism causing an infection in AIDS patients.

Pneumocystic carinii

Pneumocystic carinii is the most common organism causing an infection in ____ patients.

AIDS

Name eight other disorders associated with AIDS patients

fatty liver infiltration hepatomegaly hepatitis non-Hodgkin's lymphoma candidiasis cholangitis cholecystitis Kaposi's sarcoma

What finding is a common complication of renal transplantation and gynecologic, vascular, or urological surgery?

lymphoceles

_____ are common complication of pelvic surgery

lymphoceles

Lymphoceles are common complications of ____ surgery

pelvis

Lymphoceles are caused by:

leakage of lymph from a renal allograft, or by surgical disruption of the lymphatic channels

lymphoceles

What are the sonographic findings associated with acute rejection of a renal transplant?

enlarged transplant decreased cortical echogenicity indistinct corticomedullary boundary prominent hypoechoic medullary pyramids peritransplant fluid collections

Which laboratory value is most specific for hepatocellular damage?

Alanine aminotransferase (ALT)

Alanine aminotransferase was formerly known as

serum glutamic pyruvic transaminase (SGPT)

Alanine Aminotransferase (ALT) is present in high concentration within the ____.

hepatocytes

____ should be elevated in the presence of liver damage.

ALT

alanine aminotransferase should be elevated in the presence of

liver damage

Why is aspartate aminotransferase (AST) not specific for liver damage?

has a wide tissue distribution.

Aspartate aminotransferase is formerly known as:

serum glutamic oxaloacetic transiminase (SGOT)

AST has a wide tissue distribution. It is present in the tissues of the ___, ___, ____, _____, and _____

liver heart skeletal muscle kidney brain

With decreasing renal function, what two waste products increase in serum concentration?

Creatinine blood urea nitrogen

____ and _____ are waste products that are primarily removed from the blood by kidney filtration

creatinine blood urea nitrogen

Creatinine and blood urea nitrogen are waste products that are primarily removed from the blood by ______

kidney filtration

When renal function _____, creatinine and blood urea nitrogen serum concentrations increase.

decrease

Name three abdominal masses associated with the elevation of alpha-fetoprotein

hepatocellular carcinoma metastatic liver disease hepatoblastoma

Hepatocellular carcinoma, metastatic liver disease, and hepatoblastomas are three abdominal masses associated with elevation of what?

alpha-fetoprotein

What four factors are associated with the increase of prostate specific antigen (PSA) in the blood?

patient age prostate volume benign prostatic hypoplasia prostate cancer

Patient age, prostate volume, benign prostatic hyperplasia, and prostate cancer are four factors associated with increases in ______ in the blood.

prostate specific antigen (PSA)

The crus of the diaphram lies ____ to the aorta

The crus of the diaphragm lies ____ to the celiac axis.

superior

The crus of the diaphragm lies _____ to the inferior vena cava

posterior

The crus of the diaphragm lies ____ and ____ to the adrenal glands.

medial posterior

What three arteries supply the adrenal glands bilaterally?

suprarenal branch of the inferior phrenic artery suprarenal branch of the aorta suprarenal branch of the renal artery

The suprarenal branch of the inferior phrenic artery, suprarenal branch of the aorta, and the suprarenal branch of the renal artery supply the _____ bilaterally with arterial blood.

adrenal glands

Into which vessel does the right suprarenal (adrenal) vein drain?

directly into the inferior vena cava

The ___ suprarenal vein drains directly into the inferior vena cava

right

Into which vessel does the left suprarenal (adrenal) vein drain?

left renal vein

The ____ suprarenal vein drains into the left renal vein.

left

In what locations can pheochromocytomas be found?

adrenal medulla organ of Zuckerkandl near the aortic bifurcation paravertebral sympathetic ganglia

Pheochromocytomas cause hypersecretion of what substances?

catecholamines (dopamine, norephinephrine, and ephinephrine)

_____ cause hypersecretion of what substances?

catecholamines

Catecholamines

dopamine, norephinephrine, and epinephrine

What four criteria define a nonfunctioning cortical adenoma?

a unilateral mass no history of malignancy elsewhere no biochemical evidence of adrenal hyperfunctioning adrenal mass less than 3 cm in diameter

Name the three most common primary sources of carcinoma that metastasize to the adrenal gland.

lung breast melanoma

What tumor of the adrenal gland is seen as an echogenic mass with an associated propagation speed artifact?

adrenal myelolipomas

_____ are commonly seen as an echogenic mass in the adrenal bed

adrenal myelolipomas

What two tumors originate from the adrenal medulla.

pheochromocytoma neuroblastoma

Pheochromocytomas and neuroblastomas originate from the ____

adrenal medulla

Name the three compartments of the retroperitoneum

perirenal space anterior pararenal space posterior pararenal space

The perirenal space, anterior pararenal space, and posterior pararenal space are the three compartments of the:

retroperitoneum

Name structures that are retroperitoneal in location (11)

kidneys are ureters inferior vena cava pancreas ascending and descending colon lymph nodes bladder adrenal glands aorta portions of the duodenum prostate uterus

retroperitoneal

What are the three branches of the celiac axis?

common hepatic artery left gastric artery splenic artery

The common hepatic artery, left gastric artery, and the splenic artery are branches of the:

celiac axis

What is the definition of a true aortic aneurysm?

dilatation which involves all three layers of the aorta

true aortic aneurysm

Most aortic aneurysms are in the _____, and usually do not involve the ____

distal aorta renal arteries

What are two different types of true aneurysms?

fusiform saccular

Spindle-shaped dilatation of the aorta

fusiform true aortic aneurysm

Localized spherical outpouching of the aortic wall

saccular true aortic aneurysm

What is the definition of a false aneurysm?

result from injury to the vessel wall where blood extravasates from the vessel. The blood surrounding the vessel is retained and walled off by the surrounding tissues.