Hagen Ch. 27 Neonatal and Pediatric Kidney

Question 1

A pelvocaliceal dilation without ureteral dilation is seen with which one of the following conditions?
Select one:
a. Posterior urethral valve obstruction
b. Bladder outlet obstruction
c. Ureteropelvic junction obstruction 
d. Multicystic dysplastic kidney disease

Answer 1

c. Ureteropelvic junction obstruction

Question 2

Between which one of the following ranges of age does the incidence of Wilms tumor peak?
Select one:
a. 1 to 3 years
b. 2 to 5 years 
c. 3 to 6 years
d. 4 to 6 years

Answer 2

b. 2 to 5 years

Question 3

Bilateral renal enlargement is seen with which one of the following conditions?
Select one:
a. Nephroblastoma
b. Prune-belly syndrome
c. Multicystic dysplastic kidney
d. Autosomal recessive polycystic kidney disease

Answer 3

d. Autosomal recessive polycystic kidney disease

Question 4

Clinical signs of renal vein thrombosis in the neonate include all of the following except:
Select one:
a. Renal enlargement
b. Hematuria
c. High platelet count 
d. Proteinuria

Answer 4

c. High platelet count

Question 5

Conditions in the newborn associated with renal abnormalities include all of the following except:
Select one:
a. Hematuria
b. Vomiting 
c. Oliguria
d. Hypertension

Answer 5

b. Vomiting

Question 6

Conditions that may lead to adrenal hemorrhage include all of the following except:
Select one:
a. Difficult delivery
b. Large fetus
c. Neonatal hypoxia
d. Hydronephrosis

Answer 6

d. Hydronephrosis

Question 7

Differential considerations for hydronephrosis include all of the following except:
Select one:
a. Extrarenal pelvis
b. Functional dilation
c. Parapelvic cyst
d. Renal vein thrombosis

Answer 7

d. Renal vein thrombosis

Question 8

If the ipsilateral renal is absent or ectopic in location, then the adrenal gland:
Select one:
a. Is larger in size.
b. Remains in the renal fossa.
c. Demonstrates a hyperechoic echo pattern.
d. Is absent or ectopic in location.

Answer 8

b. Remains in the renal fossa.

Question 9

Neuroblastoma is typically a malignant tumor of the \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_.
Select one:
a. Kidney 
b. Adrenal gland
c. Liver
d. Pancreas

Answer 9

b. Adrenal gland

Question 10

Renal vein thrombosis is more prevalent in infants of \_\_\_\_\_\_\_\_\_ mothers.
Select one:
a. Hypertensive
b. Obese
c. Diabetic 
d. Hypotensive

Answer 10

c. Diabetic

Question 11

Sonographic findings in adrenal hemorrhage in the neonate include all of the following conditions except:
Select one:
a. Blunting of the superior pole of the underlying kidney
b. Ovoid enlargement of the adrenal gland
c. Irregular-shaped small gland
d. Complex echo texture

Answer 11

c. Irregular-shaped small gland

Question 12

The adrenal medulla in the neonate appears as a(n):
Select one:
a. Hypoechoic central focus
b. Echogenic stripe 
c. Isoechoic to the adrenal cortex
d. Both A and C

Answer 12

b. Echogenic stripe

Question 13

The best way to demonstrate the dilated ureter at the ureteropelvic junction is with a \_\_\_\_\_\_\_\_\_\_\_ scan.
Select one:
a. Coronal 
b. Anterior
c. Upright
d. Posterior

Answer 13

a. Coronal

Question 14

The left adrenal gland:
Select one:
a. Extends lateral to the kidney.
b. Lies immediately inferior to the upper pole of the kidney.
c. Extends medial to the kidney.
d. Is ovoid in shape in the longitudinal plane.

Answer 14

c. Extends medial to the kidney.

Question 15

The most common cause of bladder outlet obstruction in the male neonate is which one of the following?
Select one:
a. Ureteropelvic junction obstruction
b. Ureteral orifice obstruction
c. Posterior urethral valve obstruction 
d. Bladder tumor

Answer 15

c. Posterior urethral valve obstruction

Question 16

The normal renal length in the pediatric patient varies with \_\_\_\_\_\_\_\_\_\_\_.
Select one:
a. Age 
b. Weight
c. Gender
d. Ethnicity

Answer 16

a. Age

Question 17

When empty, the bladder wall thickness should not exceed \_\_\_\_\_ millimeter (mm).
Select one:
a. 2
b. 3
c. 5 
d. 7

Answer 17

c. 5

Question 18

Which one of the following conditions is the most common cause of renal cystic disease in the neonate?
Select one:
a. Medullary cystic disease
b. Parapelvic cysts
c. Multicystic dysplastic kidney (MDK) disease
d. Polycystic kidney disease (PKD)

Answer 18

c. Multicystic dysplastic kidney (MDK) disease

Question 19

Which one of the following conditions occurs when the fetus is stressed during a difficult delivery or during a hypoxia insult?
Select one:
a. Renal hemorrhage
b. Acute renal failure
c. Adrenal hemorrhage 
d. Urinary obstruction

Answer 19

c. Adrenal hemorrhage

Question 20

Which one of the following genitourinary problems is commonly associated with the prune-belly syndrome?
Select one:
a. Small bladder
b. Ureteral reflux 
c. Chronic pyelonephritis
d. Multicystic dysplastic kidney

Answer 20

b. Ureteral reflux

Question 21

Which one of the following malignant tumors is most frequent in the neonate and infant?
Select one:
a. Congenital mesoblastic nephroma
b. Neuroblastoma
c. Wilms tumor 
d. Renal cell carcinoma

Answer 21

c. Wilms tumor

Question 22

Which one of the following statements regarding ectopic ureteroceles is incorrect?
Select one:
a. Are more commonly found in male patients.
b. Are found more often on the left side.
c. Result from an ectopic insertion of the distal ureter.
d. Cause cystic dilation of the distal ureter.

Answer 22

a. Are more commonly found in male patients.

Question 23

Which one of the following structures is thin in the neonate with echogenicity similar to or slightly greater than the normal liver parenchyma?
Select one:
a. Medullary pyramids
b. Cortex 
c. Arcuate arteries
d. Renal pelvis

Answer 23

b. Cortex

Question 24

Which one of the following structures lies at the bases of the medullary pyramids and appears as echogenic structures?
Select one:
a. Arcuate arteries 
b. Ectopic ureterocele
c. Posterior urethral valves
d. Renal cortex

Answer 24

a. Arcuate arteries

Question 25

Which one of the following structures should not be mistaken for dilated calyces or cysts?
Select one:
a. Renal cortex
b. Arcuate arteries
c. Renal vein
d. Medullary pyramids

Answer 25

d. Medullary pyramids