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KIDNEYS Flashcards

1
Q

the ______ is the outer renal parenchyma from renal sinus to renal capsule

A

renal cortex

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2
Q

the ______ is the inner portion of the kidney from the base of pyramids to center of kidney.

A

renal medulla

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3
Q

the ______ is the inner hyperechoic portion of the kidney which contains fat, calyces, renal pelvis, connective tissue, renal vessels, and lymphatics

A

renal sinus

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4
Q

the ______ is the anechoic, usually spaced triangles of collecting tubules between cortex and renal sinus. commonly seen in neonatal and pediatric kidneys.

A

medullary pyramids

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5
Q

the ______ is the funnel-shaped transition from the major calyces to the ureter

A

renal pelvis

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6
Q

the ______ is the medial opening for entry/exit of artery, vein, and ureter

A

renal hilum

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7
Q

the ______ is 3 extensions of the renal pelvis

A

major calyces

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8
Q

the ______ is the extensions of the major calyces that collects urine from the medullary pyramids.

A

minor calyces

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9
Q

the ______ is the apex of the medullary pyramids.

A

renal papilla

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10
Q

______ is the fibrous shealth enclosing the kidney and the adrenal glands. this is referred to as the perirenal space.

A

gerota’s fascia

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11
Q

______ is the functional unit of the kidney consisting of the renal corpuscle, proximal convoluted tubule, descending and ascending limbs of Henle’s loop, distal convoluted tubule, and collecting tubules.

A

nephron

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12
Q

______ consists of glomerulus and gromerular capsule.

A

renal corpuscle (malpighian body)

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13
Q

What are the 5 divisions from the main renal artery?

A

main renal>segmental>interlobar>arcuate>interlobular

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14
Q

the renal variant in which the developing kidneys fuse in the pelvis and one kidney ascends to its normal position, carrying the other one with it across midline.

A

crossed fused renal ectopia

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15
Q

the renal variant in which the kidneys may fuse to form a round mass in the pelvis.

A

discoid or pancake kidney

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16
Q

renal variant in which there is cortical thickening on the lateral aspect of the left kidney.

A

dromedary hump

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17
Q

This defect is also known as fetal lobulation which is partial fusion of the renunculi (embryonic kidney)

A

junctional parenchymal defect

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18
Q

______ is a renal variant is which the collecting system is duplicated. can be complete (2 ureters) or incomplete (one ureter).

A

duplex kidney

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19
Q

with complete duplex kidneys, (2 ureters) the upper pole is ureter is inserted ectopically which has a frequent complication of a ______.

A

ureterocele

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20
Q

a normal variant of prominent renal cortical parenchyma located between two medullary pyramids.

A

column of bertin (septal cortex)

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21
Q

renal agenesis is associated with ______ and ______.

A

oligohydramnios

pulmonary hypoplasia

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22
Q

unilateral renal agenesis may be an isolated congenital malformation or may be associated with chromosomal abnormalities. some associations include:

A

bicornuate or didelphys uteri
seminal vesicle agenesis
congenital cardiac malformations
VACTERL syndrome

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23
Q

VACTERL syndrome

A 
vertebral defects
anal atresia
cardiovascular anomalies
tracheoesophageal fistula
renal anomalies
limb defects
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24
Q

______ lies outside the renal sinus sonographically appearing as a cystic collection medial to the renal hilum.

A

extrarenal pelvis

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25
______ is a common cause of urinary obstruction in the male neonatal population.
posterior uretheral valve
26
______ is an obstruction due to a flap of mucosa that has a slit-like opening in the area of the prostatic urethra.
posterior uretheral valve
27
posterior uretheral valve sonographic findings include:
large bladder hydroureter hydronephrosis urinoma
28
most renal cysts are simple cortical cysts that originate from obstructed ______
uniniferous tubules
29
______ cysts are calyceal diverticula that sonographically appear as simple cysts
pylogenic
30
______ cysts are cortical cysts that bulge into the central sinus of the kidney
parapelvic
31
______ cysts are lymphatic in the central sinus.
peripelvic
32
______ is an inherited renal disease that results in bilateral renal enlargement and microscopic cysts
autosomal recessive polycystic kidney disease (ARPKD)
33
______ is an inherited disease that results in the development of renal, liver, and pancreatic cysts late in life.
autosomal dominant polycystic kidney disease (ADPKD)
34
ARPKD may be detected in utero with ______
oligohydramnios
35
______ refers to the typical physical appearance of a neonate as a direct result of oligohydramnios and compression in utero
potter syndrome
36
causes of potter syndrome include:
``` bilat renal agenesis ARPKD ADPKD multicystic renal dysplasia obstructive uropathy (PUV defect) early rupture of membranes ```
37
Most common cause of an abdominal mass in newborns is ______
multicystic dysplastic kidney
38
______ is a form of renal dysplasia resulting in multiple noncommunicating cysts with the absence of renal parenchyma.
MCDK
39
MCDK is the result of atresia of the ______ during fetal development
ureteropelvic junction
40
MCDK has been reported in various syndromes such as ______, ______, & ______.
beckwith-wiedemann trisomy 18 VACTERL
41
Ureteropelvic junction obstruction is caused by ______, ______, ______
ureteral hypoplasia high insertion of ureter into renal pelvis compression by segmental artery
42
congenital dysplastic cystic dilatation of the medullary pyramids due to tubular ectasia or dysplasia.
medullary sponge kidney
43
the development of multiple cysts in chronically failed kidneys during long-term hemodialysis
acquired cystic disease
44
______ presents in the 2nd and 3rd decade of life characterized by retinal and central nervous system hemangioblastomas.
Von Hippel Lindau
45
______ is a hyperechoic, benign renal tumor, 80% involvement in the rt kidney.
angiomyolipoma
46
a multi-system genetic disease. classic presentation includes: seizures, mental retardation, and facial angiofibromas
tuberous sclerosis
47
patients with tuberous sclerosis have and increased chance of ______ & ______.
renal cysts | angiomyolipomas (typically bilat in pt with tuberous sclerosis)
48
the most common solid renal mass in the adult
renal cell carcinoma (RCC)
49
in patients with RCC, the most common site for mets is ______
lungs
50
tumor extension into the ______ & ______ is common in patients with RCC.
renal vns | ivc
51
What is the common presentation of RCC?
``` hematuria flank pain weight loss fever HTN hypercalcimia ```
52
Males with RCC may present with ______ due to occlusion of the testicular (gonadal vn).
varicoceles
53
malignant cells from ______ & ______ can mets to the kidneys
leukemia | lymphoma
54
______ is the most common childhood renal tumor
Wilm's tumor (nephroblastoma)
55
The mean age of a Wilm's tumor diagnosis is ______
3.5 yrs
56
______ is an inflammation of the kidney or kidneys- bacteria is spread to the kidney through the bloodstream or more commonly, from the lower urinary tract.
acute pyelonephritis
57
the formation of air within the kidney parenchyma secondary to bacterial infiltration. More commonly occuring in diabetics, immunosuppressed, & pt with urinary tract obstruction
emphysematous pyelonephritis
58
renal injury induced by recurrent renal infection due to anatomic anomalies, obstructive lesions, or ureteral reflux
chronic pyelonephritis
59
type of chronic phelonephritis resulting from chronic infections due to long term obstruction
xanthogranulomatous pyelonephritis (XGPN)
60
Associated findings with XGPN include:
``` renal enlargement parenchymal abscess staghorn calculi papillary necrosis hydronephrosis pyonephrosis loss of cortical-medullary boundry cortical thinning ```
61
purulent material in the collecting system of the kidney associated with an infection secondary to renal obstruction
pyonephrosis
62
______ is the most common renal fungal disease
candidiasis
63
fungal infection resulting from hematogenous seeding or ascend from the bladder
mycetoma (fungal ball)
64
AKI is commonly defined as an abdupt decline in renal function, manifested by decreased ______, elevation of ______ & ______.
urinary output plasma blood urea nitrogen (BUN) creatinine
65
What are the three main mechanisms of AKI
prerenal failure intrinsic (intrarenal) renal failure postrenal failure
66
examples of prerenal failure
hypotension volume depletion decreased cardiac output
67
examples of intrinsic renal failure
acute tubular necrosis glomerular disease interstitial nephritis (drugs or contrast agent) autoimmune disease
68
examples of postrenal failure
bilat renal obstruction
69
What is the most common cause of renal vein thrombosis
nephrotic syndrome
70
What are sonographic findings with renal vein thrombosis
dilated thrombosed renal vn absent intrarenal venous flow enlarged, hypoechoic kidney high resistance renal artery waveform (high RI)
71
______ is a sudden cause of prerenal failure that presents as acute flank pain, hematuria, and a sudden rise in blood pressure.
renal artery thrombosis
72
What is the most common cause of intrarenal (intrinsic) acute kidney injury?
acute tubular necrosis
73
acute tubular necrosis (ATN) results in ______ or ______.
prolonged ischemia | nephrotoxins (drugs & contrast agents)
74
______ is an inflammatory response resulting in glomerular damage caused by infectious and noninfectious causes.
acute glomerulonephritis
75
The most common infectious cause of acute glomerulonephritis is ______.
streptococcus species
76
Acute GN presents with symptoms such as sudden onset of hematuria, proteinuria, and ______
red blood cell casts in urine
77
three common areas of obstruction by a stone include:
ureterovesical junction (UVJ)- most common ureteropelvic junction pelvic brim
78
an RI of >0.7 is suggestive of ______
obstructive hydronephrosis
79
The most common causes of newborn/prenatal hydronephrosis are ______, ______, & ______
vesicoureteral reflux non-obstructive hydronephrosis UPJ obstruction
80
bilat hydro in pediatrics is suggestive of ______ or ______.
``` ureterocele PUV obstruction (males) ```
81
______ is the most common cause of hydro in pediatric patients
UPJ obstruction
82
A megaureter is a wide ureter, greater than ______ mm in diameter
7
83
secondary megaureter results from abnormalities that involve the bladder or urethera such as ______, ______, and ______.
neurogenic bladder prune belly syndrome posterior uretheral valves
84
most common neonatal abdominal mass?
multicystic dysplastic kidney
85
most common neonatal adrenal mass?
adrenal hemorrhage
86
most common childhood adrenal mass?
neuroblastoma
87
most common neonatal renal mass?
multicystic dysplastic kidney
88
most common childhood renal mass?
Wilm's tumor
89
disorders of calcium metabolism resulting in the formation of calcium renal stones and deposition of calcium in the renal parenchyma
nephrocalcinosis
90
color Doppler artifact that appears as a rapidly alternating mixture of red and blue Doppler signals distal to a strong reflective surface such as a renal stone.
twinkle sign
91
causes of medullary nephrocalcinosis
primary hyperparathyroidism renal tubular acidosis medullary sponge kidney
92
causes of cortical nephrocalcinosis
chronic glomerulonephritis renal cortical necrosis chronic transplant rejection
93
ischemia of the medullary pyramids
papillary necrosis
94
the clinical diagnosis of papillary necrosis is made by identifying ______
sloughed papilla in the urine
95
______ is associated with diabetes mellitus, urinary tract obstruction, analgesic abuse, sickle cell disease
papillary necrosis
96
increased renal sinus fat that replaces normal renal parenchyma
renal sinus lipomastosis
97
The apex of the bladder points anteriorly and is connected to the umbilicus by the ______
median umbilical ligament (urachus)
98
the ureters enter the bladder at the ______ angle of the trigone and exit the bladder via the urethra
superolateral
99
the normal bladder wall thickness is usually ______ mm in a non-distended & ______ mm within a distended bladder
<5 | <3
100
______ are herniations of the bladder mucosa through the bladder wall musculature.
bladder diverticula
101
Most acquired bladder diverticula are associated with longstanding bladder outlet obstruction due to ______
benign prostatic hypertrophy
102
______ is a cystic dilatation of fetal urachus.
urachal cyst
103
in the pelvis, the ureters cross ______ to the common iliac vessels to insert upon the trigone of the bladder.
anterior
104
The ureters exit the kidney ______ to the renal artery & vein
posterior
105
a cyst-like enlargement of the lower end of the ureter which projects into the bladder lumen at the ureterovesical junction
ureteroceles
106
ureteroceles are most commonly found win association with ______
duplex kidney
107
______ is the most common bladder neoplasm
transitional cell carcinoma (TCC)
108
A normal renal artery demonstrates ______ resistance perfusion
low
109
what is the resistive index equation
peak systolic - end diastolic / peak systolic
110
normal RI is < ______
0.7
111
if the RI = 1.0, then distole is ______.
absent
112
RAR
renal artery/AO ratio >3.5
113
______ is the most common cause of renal disease leading to kidney transplantation
diabetes
114
poor function of the renal transplant may result in ______ in the immediate posttransplantation period
acute tubular necrosis
115
sonographic findings of acute transplant rejection include:
renal enlargement decreased echogenicity loss of cortical medullary boundary increased RI
116
an RI > ______ in a transplant kidney patient is considered abnormal &
0. 8 | 0. 7

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