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ABD BOARD > KIDNEYS > Flashcards

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
Q

______ is a common cause of urinary obstruction in the male neonatal population.

A

posterior uretheral valve

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26
Q

______ is an obstruction due to a flap of mucosa that has a slit-like opening in the area of the prostatic urethra.

A

posterior uretheral valve

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27
Q

posterior uretheral valve sonographic findings include:

A

large bladder
hydroureter
hydronephrosis
urinoma

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28
Q

most renal cysts are simple cortical cysts that originate from obstructed ______

A

uniniferous tubules

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29
Q

______ cysts are calyceal diverticula that sonographically appear as simple cysts

A

pylogenic

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30
Q

______ cysts are cortical cysts that bulge into the central sinus of the kidney

A

parapelvic

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31
Q

______ cysts are lymphatic in the central sinus.

A

peripelvic

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32
Q

______ is an inherited renal disease that results in bilateral renal enlargement and microscopic cysts

A

autosomal recessive polycystic kidney disease (ARPKD)

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33
Q

______ is an inherited disease that results in the development of renal, liver, and pancreatic cysts late in life.

A

autosomal dominant polycystic kidney disease (ADPKD)

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34
Q

ARPKD may be detected in utero with ______

A

oligohydramnios

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35
Q

______ refers to the typical physical appearance of a neonate as a direct result of oligohydramnios and compression in utero

A

potter syndrome

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36
Q

causes of potter syndrome include:

A 
bilat renal agenesis
ARPKD
ADPKD
multicystic renal dysplasia
obstructive uropathy (PUV defect)
early rupture of membranes
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37
Q

Most common cause of an abdominal mass in newborns is ______

A

multicystic dysplastic kidney

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38
Q

______ is a form of renal dysplasia resulting in multiple noncommunicating cysts with the absence of renal parenchyma.

A

MCDK

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39
Q

MCDK is the result of atresia of the ______ during fetal development

A

ureteropelvic junction

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40
Q

MCDK has been reported in various syndromes such as ______, ______, & ______.

A

beckwith-wiedemann
trisomy 18
VACTERL

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41
Q

Ureteropelvic junction obstruction is caused by ______, ______, ______

A

ureteral hypoplasia
high insertion of ureter into renal pelvis
compression by segmental artery

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42
Q

congenital dysplastic cystic dilatation of the medullary pyramids due to tubular ectasia or dysplasia.

A

medullary sponge kidney

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43
Q

the development of multiple cysts in chronically failed kidneys during long-term hemodialysis

A

acquired cystic disease

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44
Q

______ presents in the 2nd and 3rd decade of life characterized by retinal and central nervous system hemangioblastomas.

A

Von Hippel Lindau

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45
Q

______ is a hyperechoic, benign renal tumor, 80% involvement in the rt kidney.

A

angiomyolipoma

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46
Q

a multi-system genetic disease. classic presentation includes: seizures, mental retardation, and facial angiofibromas

A

tuberous sclerosis

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47
Q

patients with tuberous sclerosis have and increased chance of ______ & ______.

A

renal cysts

angiomyolipomas (typically bilat in pt with tuberous sclerosis)

48
Q

the most common solid renal mass in the adult

A

renal cell carcinoma (RCC)

49
Q

in patients with RCC, the most common site for mets is ______

A

lungs

50
Q

tumor extension into the ______ & ______ is common in patients with RCC.

A

renal vns

ivc

51
Q

What is the common presentation of RCC?

A 
hematuria
flank pain
weight loss
fever
HTN
hypercalcimia
52
Q

Males with RCC may present with ______ due to occlusion of the testicular (gonadal vn).

A

varicoceles

53
Q

malignant cells from ______ & ______ can mets to the kidneys

A

leukemia

lymphoma

54
Q

______ is the most common childhood renal tumor

A

Wilm’s tumor (nephroblastoma)

55
Q

The mean age of a Wilm’s tumor diagnosis is ______

A

3.5 yrs

56
Q

______ 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.

A

acute pyelonephritis

57
Q

the formation of air within the kidney parenchyma secondary to bacterial infiltration. More commonly occuring in diabetics, immunosuppressed, & pt with urinary tract obstruction

A

emphysematous pyelonephritis

58
Q

renal injury induced by recurrent renal infection due to anatomic anomalies, obstructive lesions, or ureteral reflux

A

chronic pyelonephritis

59
Q

type of chronic phelonephritis resulting from chronic infections due to long term obstruction

A

xanthogranulomatous pyelonephritis (XGPN)

60
Q

Associated findings with XGPN include:

A 
renal enlargement
parenchymal abscess
staghorn calculi
papillary necrosis
hydronephrosis
pyonephrosis
loss of cortical-medullary boundry
cortical thinning
61
Q

purulent material in the collecting system of the kidney associated with an infection secondary to renal obstruction

A

pyonephrosis

62
Q

______ is the most common renal fungal disease

A

candidiasis

63
Q

fungal infection resulting from hematogenous seeding or ascend from the bladder

A

mycetoma (fungal ball)

64
Q

AKI is commonly defined as an abdupt decline in renal function, manifested by decreased ______, elevation of ______ & ______.

A

urinary output
plasma blood urea nitrogen (BUN)
creatinine

65
Q

What are the three main mechanisms of AKI

A

prerenal failure
intrinsic (intrarenal) renal failure
postrenal failure

66
Q

examples of prerenal failure

A

hypotension
volume depletion
decreased cardiac output

67
Q

examples of intrinsic renal failure

A

acute tubular necrosis
glomerular disease
interstitial nephritis (drugs or contrast agent)
autoimmune disease

68
Q

examples of postrenal failure

A

bilat renal obstruction

69
Q

What is the most common cause of renal vein thrombosis

A

nephrotic syndrome

70
Q

What are sonographic findings with renal vein thrombosis

A

dilated thrombosed renal vn
absent intrarenal venous flow
enlarged, hypoechoic kidney
high resistance renal artery waveform (high RI)

71
Q

______ is a sudden cause of prerenal failure that presents as acute flank pain, hematuria, and a sudden rise in blood pressure.

A

renal artery thrombosis

72
Q

What is the most common cause of intrarenal (intrinsic) acute kidney injury?

A

acute tubular necrosis

73
Q

acute tubular necrosis (ATN) results in ______ or ______.

A

prolonged ischemia

nephrotoxins (drugs & contrast agents)

74
Q

______ is an inflammatory response resulting in glomerular damage caused by infectious and noninfectious causes.

A

acute glomerulonephritis

75
Q

The most common infectious cause of acute glomerulonephritis is ______.

A

streptococcus species

76
Q

Acute GN presents with symptoms such as sudden onset of hematuria, proteinuria, and ______

A

red blood cell casts in urine

77
Q

three common areas of obstruction by a stone include:

A

ureterovesical junction (UVJ)- most common
ureteropelvic junction
pelvic brim

78
Q

an RI of >0.7 is suggestive of ______

A

obstructive hydronephrosis

79
Q

The most common causes of newborn/prenatal hydronephrosis are ______, ______, & ______

A

vesicoureteral reflux
non-obstructive hydronephrosis
UPJ obstruction

80
Q

bilat hydro in pediatrics is suggestive of ______ or ______.

A 
ureterocele
PUV obstruction (males)
81
Q

______ is the most common cause of hydro in pediatric patients

A

UPJ obstruction

82
Q

A megaureter is a wide ureter, greater than ______ mm in diameter

A

7

83
Q

secondary megaureter results from abnormalities that involve the bladder or urethera such as ______, ______, and ______.

A

neurogenic bladder
prune belly syndrome
posterior uretheral valves

84
Q

most common neonatal abdominal mass?

A

multicystic dysplastic kidney

85
Q

most common neonatal adrenal mass?

A

adrenal hemorrhage

86
Q

most common childhood adrenal mass?

A

neuroblastoma

87
Q

most common neonatal renal mass?

A

multicystic dysplastic kidney

88
Q

most common childhood renal mass?

A

Wilm’s tumor

89
Q

disorders of calcium metabolism resulting in the formation of calcium renal stones and deposition of calcium in the renal parenchyma

A

nephrocalcinosis

90
Q

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.

A

twinkle sign

91
Q

causes of medullary nephrocalcinosis

A

primary hyperparathyroidism
renal tubular acidosis
medullary sponge kidney

92
Q

causes of cortical nephrocalcinosis

A

chronic glomerulonephritis
renal cortical necrosis
chronic transplant rejection

93
Q

ischemia of the medullary pyramids

A

papillary necrosis

94
Q

the clinical diagnosis of papillary necrosis is made by identifying ______

A

sloughed papilla in the urine

95
Q

______ is associated with diabetes mellitus, urinary tract obstruction, analgesic abuse, sickle cell disease

A

papillary necrosis

96
Q

increased renal sinus fat that replaces normal renal parenchyma

A

renal sinus lipomastosis

97
Q

The apex of the bladder points anteriorly and is connected to the umbilicus by the ______

A

median umbilical ligament (urachus)

98
Q

the ureters enter the bladder at the ______ angle of the trigone and exit the bladder via the urethra

A

superolateral

99
Q

the normal bladder wall thickness is usually ______ mm in a non-distended & ______ mm within a distended bladder

A

<5

<3

100
Q

______ are herniations of the bladder mucosa through the bladder wall musculature.

A

bladder diverticula

101
Q

Most acquired bladder diverticula are associated with longstanding bladder outlet obstruction due to ______

A

benign prostatic hypertrophy

102
Q

______ is a cystic dilatation of fetal urachus.

A

urachal cyst

103
Q

in the pelvis, the ureters cross ______ to the common iliac vessels to insert upon the trigone of the bladder.

A

anterior

104
Q

The ureters exit the kidney ______ to the renal artery & vein

A

posterior

105
Q

a cyst-like enlargement of the lower end of the ureter which projects into the bladder lumen at the ureterovesical junction

A

ureteroceles

106
Q

ureteroceles are most commonly found win association with ______

A

duplex kidney

107
Q

______ is the most common bladder neoplasm

A

transitional cell carcinoma (TCC)

108
Q

A normal renal artery demonstrates ______ resistance perfusion

A

low

109
Q

what is the resistive index equation

A

peak systolic - end diastolic / peak systolic

110
Q

normal RI is < ______

A

0.7

111
Q

if the RI = 1.0, then distole is ______.

A

absent

112
Q

RAR

A

renal artery/AO ratio >3.5

113
Q

______ is the most common cause of renal disease leading to kidney transplantation

A

diabetes

114
Q

poor function of the renal transplant may result in ______ in the immediate posttransplantation period

A

acute tubular necrosis

115
Q

sonographic findings of acute transplant rejection include:

A

renal enlargement
decreased echogenicity
loss of cortical medullary boundary
increased RI

116
Q

an RI > ______ in a transplant kidney patient is considered abnormal &

A
  1. 8

0. 7

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