Flashcard Davies Abdomen 5
What is the most common cause of acute renal failure?
acute tubular necrosis
Causes of acute tubular necrosis
shock, trauma, sepsis, and drug toxicity
_____ and _____ may be seen associated with acute tubular necrosis
renal enlargement
increased resistive index
Sonographically, how is obstructive nephropathy differentiated from nonobstructive nephropathy?
Intrarenal resistivity index greater than 0.7 only relevant to acute obstruction
obstructive nephropathy is also known as
hydronephosis
Nonobstructive nephropathy will have resistivity index values of less than ____
0.7
Obstructive nephropathy will have resistivity index values of greater than ___
0.7
What genitourinary tract anomaly is commonly associated with a contralateral UPJ obstruction?
unilateral multicystic dysplastic kidney
Unilateral multicystic displastic kidney is commonly associated with a contralateral ______
ureteropelvic junction obstruction
most common cause of obstruction in patients with acute flank pain
renal calculi
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
What is the most common location for an obstruction from a renal calculi?
ureterovesical junction
a measurement used to evaluate renal transplants, assess suspected hydronephrosis, evaluate medical renal disease, and evaluate suspected renal neoplasms
resistive index
What is resistive index?
a measurement used to evaluate renal transplants, assess suspected hydronephrosis, evaluate medical renal disease, and evaluate suspected renal neoplasms
What is the formula for resistive index?
peak systolic frequency - end diastolic frequency / peak systolic frequency
peak systolic frequency - end diastolic frequency / peak systolic frequency
resistive index
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
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
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
Describe the sonographic appearance of a ureterocele
round, cystic structures that project into the bladder lumen at the ureterovesical junction
Ureteroceles appear as round, cystic structures that project into the bladder lumen at the ______
ureterovesical junction
Name the structure that connects the apex of the bladder to the umbilicus
median umbilical ligament (urachus)
The median umbilical ligament is also known as the:
urachus
The urachus is also known as the:
medial umbilical ligament
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
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
anterior
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
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
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.
